Individual
MR. KYLE M ST. JEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2601 LAKE DR STE 201, RALEIGH, NC 27607-6689
(919) 783-4888
(919) 783-4887
Mailing address
125 STAR MAGNOLIA DR, MORRISVILLE, NC 27560-7734
(401) 524-9492
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
308475
NC
363L00000X
Nurse Practitioner
26NJ00175000
NJ
367500000X
Certified Registered Nurse Anesthetist
Primary
5866
NC
367500000X
Certified Registered Nurse Anesthetist
NR11819500
NJ
Other
Enumeration date
04/18/2006
Last updated
09/22/2022
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