Individual
CARMEN SIOUX THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2825 RANDOLPH RD, CHARLOTTE, NC 28211-1018
(704) 337-1647
(704) 377-5014
Mailing address
2080 W ARLINGTON BLVD, SUITE B, GREENVILLE, NC 27834-3770
(252) 752-2140
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
164470
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
71440
NC
367500000X
Certified Registered Nurse Anesthetist
RN170518
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689660730
—
NC
01
—
Q37230A
MEDICARE
NC
Enumeration date
09/23/2005
Last updated
10/27/2020
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