Individual
MISS SHIRA FRIEND KAZAKEWICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 751730, CHARLOTTE, NC 28275-1730
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
151859
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078272
CRNA
NC
01
—
151859
RN LICENSE
NC
Enumeration date
09/28/2007
Last updated
07/21/2014
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