Individual
KANDACE WOODARD THOMASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
145 KIMEL PARK DR STE 120, WINSTON SALEM, NC 27103-6983
(336) 768-3212
(336) 768-9019
Mailing address
145 KIMEL PARK DR STE 120, WINSTON SALEM, NC 27103-6983
(336) 768-3212
(336) 768-9019
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
084916
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0264U
BCBS
NC
01
—
16186
PARTNERS
NC
05
—
8050848
—
NC
Enumeration date
09/03/2006
Last updated
10/27/2020
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