Individual
MRS. IVELCA NINTZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1781 METROMEDICAL DR, FAYETTEVILLE, NC 28304-3862
(910) 323-1647
Mailing address
7230 MARINERS LANDING DR, FAYETTEVILLE, NC 28306-7478
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
515690
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200607460A
—
KS
05
—
8052789
—
NC
01
—
P00397220
RAILROAD-MEDICARE
NC
Enumeration date
09/26/2006
Last updated
04/10/2015
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