Provider Demographics
NPI:1518239888
Name:LINSTER, KELLI RENEE (CRNA)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:RENEE
Last Name:LINSTER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:
Other - Last Name:RAPPOLD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:11945 NORMAN LN
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-5629
Mailing Address - Country:US
Mailing Address - Phone:916-740-5467
Mailing Address - Fax:
Practice Address - Street 1:1600 EUREKA RD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3027
Practice Address - Country:US
Practice Address - Phone:916-474-6634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-02
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4134367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered