Healthcare Provider Details

I. General information

NPI: 1992086441
Provider Name (Legal Business Name): LAURA NIDAY MADISON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2011
Last Update Date: 08/14/2020
Certification Date: 08/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTMENT OF ANESTHESIOLOGY N2198 UNC HOSPITALS CB #7010
CHAPEL HILL NC
27599-7010
US

IV. Provider business mailing address

PO BOX 271647
SALT LAKE CITY UT
84127-1647
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-5136
  • Fax: 984-974-4873
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number216577
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: