=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265749402
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHIARA BUONANNO OLAYER CRNA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2010
-----------------------------------------------------
Last Update Date | 09/23/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2000 HOSPITAL DR
-----------------------------------------------------
City | MOUNT PLEASANT
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29464-3764
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-881-0100
-----------------------------------------------------
Fax | 770-874-5483
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5665 NEW NORTHSIDE DR SUITE 320
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30328-5831
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-874-5400
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367500000X
-----------------------------------------------------
Taxonomy Name | Certified Registered Nurse Anesthetist
-----------------------------------------------------
License Number | 4376
-----------------------------------------------------
License Number State | SC
-----------------------------------------------------