Individual
LESLIE T GAYNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9263 MEDICAL PLAZA DR STE E, CHARLESTON, SC 29406-7112
(843) 572-1228
Mailing address
9263 MEDICAL PLAZA DR STE E, CHARLESTON, SC 29406-7112
(843) 572-1228
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
042622
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25890
LICENSE
SC
01
—
RN345306L
LICENSE
PA
Enumeration date
05/11/2010
Last updated
01/31/2024
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