Healthcare Provider Details

I. General information

NPI: 1467168708
Provider Name (Legal Business Name): AMY LOUISE KRET CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY LOUISE VOTARY CRNA

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9263 MEDICAL PLAZA DR STE E
CHARLESTON SC
29406-7112
US

IV. Provider business mailing address

4813 AUGUSTA DR
GROVES TX
77619-2001
US

V. Phone/Fax

Practice location:
  • Phone: 843-572-1228
  • Fax:
Mailing address:
  • Phone: 478-361-4843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number869521
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number144883
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number30369
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: