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General NPI Number Information
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NPI Number | 1053608109
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Entity Type | Individual
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Provider Name | JOHN ARNOLD SANDRU CRNA
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Gender | Male
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Dates
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Enumeration Date | 07/08/2011
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 2417 ATRIUM DR STE 101
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City | RALEIGH
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State | NC
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Zip | 27607-6673
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Country | US
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Telephone | 800-242-5080
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Fax | 727-900-7981
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Provider Business Mailing Address
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Address Line | PO BOX 946619
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City | ATLANTA
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State | GA
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Zip | 30394-6619
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Country | US
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Telephone | 800-242-5080
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Fax | 727-900-7770
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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 | D-127601
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3220
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License Number State | NC
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