Healthcare Provider Details

I. General information

NPI: 1356848006
Provider Name (Legal Business Name): DR. SYLWIA RATHBUN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2018
Last Update Date: 02/04/2021
Certification Date: 02/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10030 GILEAD RD
HUNTERSVILLE NC
28078-7545
US

IV. Provider business mailing address

16209 HALLATON DR
HUNTERSVILLE NC
28078-2207
US

V. Phone/Fax

Practice location:
  • Phone: 704-316-4000
  • Fax:
Mailing address:
  • Phone: 908-248-7740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number604073
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number329235
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: