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General NPI Number Information
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NPI Number | 1164789293
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Entity Type | Individual
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Provider Name | TAYA CHRISTINE KRETZ-NOTELLE CRNA
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Gender | Female
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 01/29/2022
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Provider Practice Location Address
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Address Line | 7 INDEPENDENCE PT STE 300
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City | GREENVILLE
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State | SC
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Zip | 29615-4569
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Country | US
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Telephone | 864-522-3700
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Fax | 864-522-3705
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Provider Business Mailing Address
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Address Line | 300 E MCBEE AVE FL 4
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City | GREENVILLE
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State | SC
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Zip | 29601-2842
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Country | US
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Telephone | 864-522-8614
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Fax | 260-408-8014
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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 | 23774
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License Number State | SC
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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 | 28155930A
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License Number State | IN
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