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General NPI Number Information
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NPI Number | 1336685684
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Entity Type | Individual
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Provider Name | ELIZABETH ANN WATERBURY CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/10/2017
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 2201 S STERLING ST
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City | MORGANTON
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State | NC
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Zip | 28655-4044
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Country | US
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Telephone | 507-429-0288
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Fax |
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Provider Business Mailing Address
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Address Line | 1762 BOST RD
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City | MORGANTON
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State | NC
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Zip | 28655-7082
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Country | US
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Telephone | 507-429-0288
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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 | R 185257-4
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License Number State | MN
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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 | 6446
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License Number State | NC
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