Individual
SANDI L DISTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
155 MEMORIAL DR, PINEHURST, NC 28374-8710
(910) 715-1233
(910) 715-1943
Mailing address
PO BOX 3000, PINEHURST, NC 28374-3000
(910) 715-1233
(910) 715-1943
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
154344
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8052120
—
NC
Enumeration date
06/09/2006
Last updated
11/29/2007
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