Healthcare Provider Details

I. General information

NPI: 1982094355
Provider Name (Legal Business Name): DAVID C MAPILE CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2015
Last Update Date: 04/01/2022
Certification Date: 04/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 TILGHMAN DR
DUNN NC
28334-5510
US

IV. Provider business mailing address

802 TILGHMAN DR
DUNN NC
28334-5510
US

V. Phone/Fax

Practice location:
  • Phone: 910-892-4248
  • Fax:
Mailing address:
  • Phone: 910-892-4248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001247002
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number229587
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024172290
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number229587
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: