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NPI Code Detail

MEDICARE: PATRICIA D STORTZ CRNA

MEDICARE: PATRICIA D STORTZ CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistAPN2228SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851393326
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA D STORTZ CRNA
Provider Business Mailing Address
First Line : 300 SINGLETON RIDGE RD
Second Line :
City : CONWAY
State : SC
Zip : 29526-9142
Country : US
Telephone Number : 843-347-8037
Fax Number :
Provider Business Practice Location Address
First Line : 300 SINGLETON RIDGE RD
Second Line :
City : CONWAY
State : SC
Zip : 29526-9142
Country : US
Telephone Number : 843-347-8037
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2005
Last Update Date : 08/13/2010

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Directions to “ PATRICIA D STORTZ CRNA” Practice Location

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