Healthcare Provider Details

I. General information

NPI: 1740370741
Provider Name (Legal Business Name): TORA M MORRISON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PALMETTO HEALTH BAPTIST 1330 TAYLOR ST AT MARION
COLUMBIA SC
29220-0001
US

IV. Provider business mailing address

325 CARDINAL LN
CHESNEE SC
29323-9684
US

V. Phone/Fax

Practice location:
  • Phone: 803-296-5010
  • Fax: 803-296-5010
Mailing address:
  • Phone: 864-578-4252
  • Fax: 864-578-4252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number029289
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: