MEDICARE: ROSEMARY E BISTI 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	174282	NC

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	:	1811995376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMARY E BISTI CRNA

Provider Business Mailing Address
First Line	:	117 BURKEWOOD DR
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27104-3936
Country	:	US
Telephone Number	:	336-768-2356
Fax Number	:

Provider Business Practice Location Address
First Line	:	1950 S HAWTHORNE RD
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-3912
Country	:	US
Telephone Number	:	336-718-0600
Fax Number	:

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	07/08/2007

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Directions to “ ROSEMARY E BISTI CRNA” Practice Location

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