Organization
GASTON ANESTHESIA ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE S HUMPHREY (PRACTICE ADMINISTRATOR)
(704) 864-8772
Entity
Organization
Contact information
Practice address
2525 COURT DR, GASTONIA, NC 28054-2140
(704) 866-2825
Mailing address
PO BOX 12845, GASTONIA, NC 28052-0017
(704) 864-8772
(704) 866-7853
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
330000
—
SC
Enumeration date
02/22/2007
Last updated
03/10/2011
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