Individual
KELLY S DULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
36000 EUCLID AVE, WILLOUGHBY, OH 44094-4625
(440) 350-0832
(440) 579-0191
Mailing address
7757 AUBURN RD STE 15, PAINESVILLE, OH 44077-9604
(440) 350-0832
(440) 354-7420
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN304555
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.11083
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3014866
—
OH
Enumeration date
09/10/2009
Last updated
04/01/2020
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