=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003848029
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KRISTEN WOLFINGER CARAHER I CRNA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/07/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 209 GLEN HAVEN DR
-----------------------------------------------------
City | CHAPEL HILL
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27516-4046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-423-2566
-----------------------------------------------------
Fax | 919-969-9895
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 209 GLEN HAVEN DR
-----------------------------------------------------
City | CHAPEL HILL
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27516-4046
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-423-2566
-----------------------------------------------------
Fax | 919-969-9895
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367500000X
-----------------------------------------------------
Taxonomy Name | Certified Registered Nurse Anesthetist
-----------------------------------------------------
License Number | 161946
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------