Individual
LISA ANN DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2825 RANDOLPH RD, CHARLOTTE, NC 28211-1018
(704) 337-1647
Mailing address
2080 W ARLINGTON BLVD, SUITE B, GREENVILLE, NC 27834-3770
(252) 752-2140
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
115157
NC
367500000X
Certified Registered Nurse Anesthetist
0024166512
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
46267
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010186161
—
VA
05
—
1235190778
—
NC
Enumeration date
03/31/2006
Last updated
11/29/2018
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