Provider Demographics
NPI:1841569316
Name:CONROY, KRISTINA E (CRNA)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:E
Last Name:CONROY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817A MADISON ST
Mailing Address - Street 2:STE 1
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-2930
Mailing Address - Country:US
Mailing Address - Phone:931-551-1795
Mailing Address - Fax:931-551-1798
Practice Address - Street 1:1817A MADISON ST
Practice Address - Street 2:STE 1
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-2930
Practice Address - Country:US
Practice Address - Phone:931-551-1795
Practice Address - Fax:931-551-1798
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16432367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered