MEDICARE: CYNTHIA A. CARSON CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	1218	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114996337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA A. CARSON CRNA

Provider Business Mailing Address
First Line	:	68 AVENUE OF OAKS
Second Line	:
City	:	SAINT HELENA ISLAND
State	:	SC
Zip	:	29920-3636
Country	:	US
Telephone Number	:	843-838-4456
Fax Number	:	843-838-4456

Provider Business Practice Location Address
First Line	:	68 AVENUE OF OAKS
Second Line	:
City	:	SAINT HELENA ISLAND
State	:	SC
Zip	:	29920-3636
Country	:	US
Telephone Number	:	843-838-4456
Fax Number	:	843-838-4456

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	08/20/2008

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