Individual
JUDSON ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3400 WAKE FOREST RD, RALEIGH, NC 27609-7317
(919) 873-9533
Mailing address
PO BOX 535395, ATLANTA, GA 30353-5321
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
224373
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
091150
NC
Other
Enumeration date
06/14/2012
Last updated
09/17/2012
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