Kim Ellen Walecka I CRNA

NPI 1053397414 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1053397414
Gender Female
Enumeration Date 12/19/2005
Last Updated 10/12/2011
Entity Type Individual
Active Over 10 years ago
Practice Location
228 OLD WESTPORT RD
DARTMOUTH MA, 02747-2353, US
Phone (774) 202-5729
Fax
Business Location
228 OLD WESTPORT RD
DARTMOUTH MA, 02747-2353, US
Phone (774) 202-5729
Fax (508) 648-1571
Toxanomy
Taxonomy Code 367500000X
License State Massachusetts
License Number 216893
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According to our database, Kim Ellen Walecka I CRNA NPI is 1053397414, taxonomy code is 367500000X and license number is 216893, license state is located at Massachusetts. Kim Ellen Walecka I CRNA physically located at 228 Old Westport Rd, Dartmouth MA, 02747-2353. NPI Number Kim Ellen Walecka I CRNA has the Individual type.

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1053397414 NPI number is provided on an as is basis without warranty of any kind. 1053397414 is maintained by the National Plan & Provider Enumeration System. The contents of Kim Ellen Walecka I CRNA are for informational purposes only.