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General NPI Number Information
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NPI Number | 1154306215
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Entity Type | Individual
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Provider Name | JAMES DAVID FORREST CRNA
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Gender | Male
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 08/06/2020
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Provider Practice Location Address
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Address Line | 747 WOODY POINT DR
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City | MURRELLS INLET
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State | SC
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Zip | 29576-7070
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Country | US
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Telephone | 843-359-9749
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Fax |
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Provider Business Mailing Address
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Address Line | 747 WOODY POINT DR
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City | MURRELLS INLET
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State | SC
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Zip | 29576-7070
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Country | US
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Telephone | 843-359-9749
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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 | 0010-00503
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License Number State | NC
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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 | 1-103958
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 1775
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License Number State | SC
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