Healthcare Provider Details

I. General information

NPI: 1396089611
Provider Name (Legal Business Name): TAMI B MAY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2012
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

566 RUIN CREEK RD
HENDERSON NC
27536-2927
US

IV. Provider business mailing address

206 HAMPTON LAKE DR
ROLESVILLE NC
27571-9315
US

V. Phone/Fax

Practice location:
  • Phone: 252-436-4565
  • Fax:
Mailing address:
  • Phone: 919-453-0682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1993236
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11016519
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: