Healthcare Provider Details

I. General information

NPI: 1790765360
Provider Name (Legal Business Name): CINDY LEE PALMER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 08/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1236 HUFFMAN MILL RD STE 2000
BURLINGTON NC
27215-8700
US

IV. Provider business mailing address

PO BOX 1832
BURLINGTON NC
27216-1832
US

V. Phone/Fax

Practice location:
  • Phone: 336-585-1770
  • Fax:
Mailing address:
  • Phone: 336-585-1770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number175534
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: