Organization
NOVANT HEALTH KERNERSVILLE OUTPATIENT SURGERY LLC
Active
Other names
CRNA PRO FEES
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LYNN O'BRIEN (ADMINISTRATOR ASC)
(336) 564-4938
Entity
Organization
Contact information
Practice address
1730 KERNERSVILLE MEDICAL PKWY, STE 304, KERNERSVILLE, NC 27284-7198
(336) 515-7000
(336) 515-7009
Mailing address
2085 FRONTIS PLAZA BLVD, WINSTON SALEM, NC 27103-5614
(336) 564-4938
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750892659
—
NC
Enumeration date
01/02/2020
Last updated
01/02/2020
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