Individual
SUSAN LYNAM HAILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10628 PARK RD, ANESTHESIA DEPARTMENT, CHARLOTTE, NC 28210-8407
(704) 667-1000
Mailing address
4400 GOLF ACRES DR, STE A, CHARLOTTE, NC 28208-5906
(704) 667-1971
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2933
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052667
—
NC
05
—
NAN632
—
SC
Enumeration date
09/05/2006
Last updated
04/21/2017
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