Individual
MRS. JOHANNA FENCL CULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
MEDICAL CENTER BOULEVARD, WINSTON SALEM, NC 27157-0001
(336) 716-0000
Mailing address
1019 ARBOR RUN DR, LEWISVILLE, NC 27023-8617
(336) 655-9650
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
078270
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
078270
CRNA
NC
Enumeration date
09/18/2007
Last updated
10/28/2020
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