Individual
CAROLYN MAVITY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2900 LAMB CIR, CHRISTIANSBURG, VA 24073-6344
(540) 731-2800
Mailing address
6727 BAY HILL CT, RADFORD, VA 24141-5676
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001-133301
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024-133301
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8935181
—
VA
05
—
8935190
—
VA
05
—
8935327
—
VA
05
—
8935335
—
VA
05
—
8935343
—
VA
Enumeration date
08/31/2006
Last updated
05/05/2008
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