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General NPI Number Information
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NPI Number | 1831118298
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Entity Type | Individual
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Provider Name | SUZANNE SMITH MCLESTER CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 301 YADKIN ST
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City | ALBEMARLE
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State | NC
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Zip | 28001-3441
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Country | US
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Telephone | 704-984-4469
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Fax |
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Provider Business Mailing Address
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Address Line | 31547 CEDAR LN
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City | ALBEMARLE
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State | NC
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Zip | 28001-6402
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Country | US
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Telephone | 704-986-2537
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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 | 171442
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License Number State | NC
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