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Individual

MRS. ANNE M SUDDUTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1 SAINT FRANCIS DR, GREENVILLE, SC 29601-3955
(864) 675-4510
Mailing address
130 WHITTINGTON DR, GREENVILLE, SC 29615-2675
(864) 297-3774

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
019491
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15463
STATE NURSING LICENSE
SC
01
19491
AANA LICENSE
SC
Enumeration date
02/23/2007
Last updated
05/11/2010
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