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Individual

KYLE AUSTIN DEITZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
509 BILTMORE AVE, ASHEVILLE, NC 28801-4601
(828) 213-1111
Mailing address
25 ACRE WOOD RD, CANTON, NC 28716-9625
(828) 776-1488

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
247204
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
247204
NC
367500000X
Certified Registered Nurse Anesthetist
6303
NC

Other

Enumeration date
12/03/2019
Last updated
01/04/2020
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