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General NPI Number Information
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NPI Number | 1043640030
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Entity Type | Individual
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Provider Name | MELISSA FOX HENRY CRNA, DNAP
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Gender | Female
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Dates
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Enumeration Date | 11/12/2013
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Last Update Date | 11/12/2013
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Provider Practice Location Address
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Address Line | 171 ASHLEY AVE DEPARTMENT OF NURSE ANESTHESIA
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City | CHARLESTON
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State | SC
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Zip | 29425-8908
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Country | US
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Telephone | 843-792-2322
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Fax | 843-792-9314
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Provider Business Mailing Address
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Address Line | 57 PONSBURY RD
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City | MT PLEASANT
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State | SC
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Zip | 29464-2690
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Country | US
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Telephone | 703-863-8208
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 18515
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License Number State | SC
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