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General NPI Number Information
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NPI Number | 1245632173
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Entity Type | Individual
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Provider Name | ELIZABETH PFLUG CRNA
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Gender | Female
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Dates
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Enumeration Date | 09/23/2014
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Last Update Date | 09/23/2014
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Provider Practice Location Address
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Address Line | MEDICAL CENTER BOULEVARD
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City | WINSTON SALEM
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State | NC
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Zip | 27157
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Country | US
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Telephone | 336-716-9997
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Fax |
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Provider Business Mailing Address
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Address Line | 472 AIRVIEW DR
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City | MOUNT AIRY
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State | NC
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Zip | 27030-5187
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Country | US
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Telephone | 704-576-9199
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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 | 104485
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License Number State | NC
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