Provider Demographics
NPI:1437471083
Name:HERRERA, KRISTEN L (CRNA)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:L
Last Name:HERRERA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:L
Other - Last Name:MARQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1613 HARRISON PKWY
Mailing Address - Street 2:SUITE 200, MAILSTOP SH-PA
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2896
Mailing Address - Country:US
Mailing Address - Phone:954-838-2371
Mailing Address - Fax:954-851-1746
Practice Address - Street 1:703 N. FLAMINGO ROAD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028
Practice Address - Country:US
Practice Address - Phone:954-838-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9291606367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered