| NPI | 1376595769 |
|---|---|
| Former Name | KRISTIN MARIE JELLISON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1059321) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2007-07-08 |