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General NPI Number Information
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NPI Number | 1194563742
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Entity Type | Individual
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Provider Name | CODY ALLAN STOGNER CRNA, RN
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Gender | Male
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Dates
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Enumeration Date | 07/17/2024
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Last Update Date | 06/17/2026
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Provider Practice Location Address
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Address Line | 100 CALLEN BLVD
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City | SUMMERVILLE
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State | SC
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Zip | 29486-2807
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Country | US
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Telephone | 854-529-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 112 HEADWATER DR
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City | SUMMERVILLE
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State | SC
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Zip | 29486-8539
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Country | US
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Telephone | 803-287-2903
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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 | 32037
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 254606
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License Number State | SC
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