Healthcare Provider Details

I. General information

NPI: 1992279723
Provider Name (Legal Business Name): HALEY SUZANNE FRANCK CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2019
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3735 GLENLAKE DR STE 250
CHARLOTTE NC
28208-6866
US

IV. Provider business mailing address

248 MAIN ST APT 542
WESTLAKE OH
44145-8169
US

V. Phone/Fax

Practice location:
  • Phone: 704-749-5800
  • Fax:
Mailing address:
  • Phone: 216-513-3642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.019831
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number6591
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: