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Individual

VLADIMIR BAUTISTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
155 MEMORIAL DR, PINEHURST, NC 28374-8710
(910) 715-1010
(910) 715-1026
Mailing address
155 MEMORIAL DR, PINEHURST, NC 28374-8710
(331) 221-1000
(630) 472-9502

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041374765
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
133834
NC

Other

Enumeration date
05/19/2014
Last updated
03/17/2018
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