Individual
EDELROSE FORTEA BACANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(805) 509-7556
Mailing address
2629 EDMONTON RD, FAYETTEVILLE, NC 28304-3768
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
6389
NC
Other
Enumeration date
07/19/2019
Last updated
06/13/2025
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