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Individual

MRS. TINA MARIE KAHWATY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607
(919) 784-3034
Mailing address
3100 SPRING FOREST RD, SUITE 130, RALEIGH, NC 27616-2880
(919) 873-9533

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
74199
NC
367500000X
Certified Registered Nurse Anesthetist
ARNP3196982
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8053382
NC
01
G3917
BC/BS OF FLORIDA NUMBER
FL
Enumeration date
07/19/2006
Last updated
08/06/2018
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