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General NPI Number Information
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NPI Number | 1336556380
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Entity Type | Individual
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Provider Name | KRISTEN REGINA STAFFORD CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/22/2014
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 800 ROSE ST
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City | LEXINGTON
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State | KY
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Zip | 40536-7001
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Country | US
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Telephone | 859-257-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 101 S HANOVER AVE APT 5K
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City | LEXINGTON
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State | KY
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Zip | 40502-1879
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Country | US
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Telephone | 845-742-4844
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001275914
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 612460
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0024175448
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 612460
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3012083
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License Number State | KY
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