Healthcare Provider Details
I. General information
NPI: 1427506625
Provider Name (Legal Business Name): ESTHER CASSIDY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/15/2016
Last Update Date: 09/12/2023
Certification Date: 09/12/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 LAUCHWOOD DR
LAURINBURG NC
28352-5501
US
IV. Provider business mailing address
316 S 3RD ST
WILMINGTON NC
28401-4507
US
V. Phone/Fax
- Phone: 910-291-7000
- Fax:
- Phone: 707-227-2955
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | 5562 |
| License Number State | NC |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | 235838 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: