Individual
KEITH AVERY SLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 HOSPITAL DR, HENDERSONVILLE, NC 28792-5272
(828) 650-8167
(828) 687-0729
Mailing address
PO BOX 1869, FLETCHER, NC 28732-1869
(828) 687-5698
(828) 650-8076
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
165427
NC
367500000X
Certified Registered Nurse Anesthetist
21305
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052769
—
NC
01
—
P00662403
RAILROAD-MEDICARE
NC
05
—
PENDING
—
SC
Enumeration date
08/31/2006
Last updated
12/13/2022
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