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General NPI Number Information
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NPI Number | 1316180425
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Entity Type | Individual
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Provider Name | JEFFERSON KRAWULSKI SOUZA CRNA
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Gender | Male
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Dates
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Enumeration Date | 04/20/2009
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 805 PAMPLICO HWY
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City | FLORENCE
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State | SC
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Zip | 29505-6047
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Country | US
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Telephone | 843-674-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 73 RICE HOPE LANE
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City | PAWLEYS ISLAND
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State | SC
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Zip | 29585
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Country | US
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Telephone | 281-658-4749
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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 | 3882
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License Number State | SC
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