Individual
AMANDA PACE YOUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1211 VIRGINIA ST, GREENSBORO, NC 27401-1313
(336) 272-0101
(336) 809-3007
Mailing address
PO BOX 29343, GREENSBORO, NC 27429-9343
(336) 272-0101
(336) 809-3001
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
165673
NC
Other
Enumeration date
08/30/2007
Last updated
08/30/2007
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