Healthcare Provider Details

I. General information

NPI: 1215275417
Provider Name (Legal Business Name): CARRIE PIERCE WALSH CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARRIE CHARLENE PIERCE

II. Dates (important events)

Enumeration Date: 01/22/2013
Last Update Date: 01/23/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MOBILE INFIRMARY CIR
MOBILE AL
36607-3513
US

IV. Provider business mailing address

255 W MICHIGAN AVE PO BOX 1123
JACKSON MI
49201-2218
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-2400
  • Fax:
Mailing address:
  • Phone: 517-787-6440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11026927
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: