Individual
AMANDA BLALOCK MCCOLLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3100
Mailing address
7409 TALL OAKS CT, RALEIGH, NC 27613-1540
(512) 633-9841
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP134144
TX
Other
Enumeration date
06/28/2017
Last updated
02/25/2022
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