MEDICARE: MS. CAREY REBECCA WILLIAMS 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	163W00000X	Registered Nurse	268632	NC
2	367500000X	Certified Registered Nurse Anesthetist	7001	NC

General Provider Information

NPI Number	:	1578231296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAREY REBECCA WILLIAMS CRNA

Provider Business Mailing Address
First Line	:	PO BOX 110566
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27709-5566
Country	:	US
Telephone Number	:	919-620-4855
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 E MAIN ST
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-3219
Country	:	US
Telephone Number	:	540-830-0447
Fax Number	:

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

Provider Enumeration Date	:	08/30/2021
Last Update Date	:	11/09/2022

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