Individual
JASON K ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
555 E CHEVES ST, FLORENCE, SC 29506-2617
(843) 777-8752
(843) 777-8705
Mailing address
555 E CHEVES ST, FLORENCE, SC 29506-2617
(843) 777-8752
(843) 777-8705
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN3116
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009008
—
LA
05
—
188795201
—
TX
05
—
AN1536
—
SC
Enumeration date
01/17/2007
Last updated
10/08/2008
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