Healthcare Provider Details

I. General information

NPI: 1982893848
Provider Name (Legal Business Name): KRISTIN ELIZABETH KREBS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN ELIZABETH DICOLA CRNA

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 01/29/2021
Certification Date: 01/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 ALEXANDER SPRING RD
CARLISLE PA
17015-6940
US

IV. Provider business mailing address

409 SOUTH SECOND STREET SUITE 2F
HARRISBURG PA
17104-1612
US

V. Phone/Fax

Practice location:
  • Phone: 717-249-1212
  • Fax: 717-519-0684
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN546217
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: