Healthcare Provider Details

I. General information

NPI: 1467899260
Provider Name (Legal Business Name): MISTINA RENEE MCGEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2013
Last Update Date: 10/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 CANE CREEK DR
GARNER NC
27529-2107
US

IV. Provider business mailing address

1320 CANE CREEK DRIVE
GARNER NC
27529
US

V. Phone/Fax

Practice location:
  • Phone: 828-284-2602
  • Fax:
Mailing address:
  • Phone: 828-284-2602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number178253
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: