Organization
KELLEY GARDNER CRNA, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEY RHENE GARDNER CRNA (PRINCIPLE)
(208) 286-0137
Entity
Organization
Contact information
Practice address
7500 HOSPITAL DR, SACRAMENTO, CA 95823-5403
(916) 423-6019
Mailing address
PO BOX 4518, STATELINE, NV 89449-4518
(866) 640-3005
(866) 640-3006
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2120
CA
Other
Enumeration date
09/21/2014
Last updated
09/21/2014
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