Healthcare Provider Details

I. General information

NPI: 1497824791
Provider Name (Legal Business Name): NANCY ASHE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

568 RUIN CREEK RD SUITE 105
HENDERSON NC
27536-2880
US

IV. Provider business mailing address

568 RUIN CREEK RD SUITE 105
HENDERSON NC
27536-2880
US

V. Phone/Fax

Practice location:
  • Phone: 252-436-1380
  • Fax: 252-436-1581
Mailing address:
  • Phone: 252-436-1380
  • Fax: 252-436-1581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number039038
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: