Healthcare Provider Details

I. General information

NPI: 1669411039
Provider Name (Legal Business Name): DORIS SPANN ARGOE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 08/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 24TH AVE
ISLE OF PALMS SC
29451-2373
US

IV. Provider business mailing address

21 24TH AVE
ISLE OF PALMS SC
29451-2373
US

V. Phone/Fax

Practice location:
  • Phone: 843-408-7382
  • Fax:
Mailing address:
  • Phone: 843-408-7382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2017
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: