Individual
HAILEE N KOECKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2825 RANDOLPH RD, CHARLOTTE, NC 28211-1018
(704) 864-8772
Mailing address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(252) 752-2140
(252) 689-6502
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
313276
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
123145
NC
Other
Enumeration date
01/24/2019
Last updated
10/23/2019
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