Individual
AZUCENA GAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2300 OPITZ BLVD., WOODBRIDGE, VA 22191
(703) 670-1313
(954) 851-1746
Mailing address
3100 SPRING FOREST RD, STE 130, RALEIGH, NC 27616-2880
(919) 882-7908
(919) 873-9821
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0001243365
VA
367500000X
Certified Registered Nurse Anesthetist
3988
CA
367500000X
Certified Registered Nurse Anesthetist
585871
CA
367500000X
Certified Registered Nurse Anesthetist
ARNP9257034
FL
Other
Enumeration date
03/01/2010
Last updated
07/20/2016
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