Individual
STEPHANIE DAVIS MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-4239
(704) 384-5636
Mailing address
200 HAWTHORNE LN, P.O. BOX 33549, CHARLOTTE, NC 28204-2515
(704) 384-4239
(704) 384-5636
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024166272
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051788
—
NC
05
—
NAN414
—
SC
Enumeration date
12/29/2006
Last updated
10/27/2020
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