Healthcare Provider Details

I. General information

NPI: 1336408681
Provider Name (Legal Business Name): STEPHEN CREIGHTON RAY CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2012
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 SWEETEN CREEK RD
ASHEVILLE NC
28803-1527
US

IV. Provider business mailing address

291 SWEETEN CREEK RD
ASHEVILLE NC
28803-1527
US

V. Phone/Fax

Practice location:
  • Phone: 828-254-0881
  • Fax: 828-258-1614
Mailing address:
  • Phone: 828-254-0881
  • Fax: 828-258-1614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number6836
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: