Individual
KENNETH J. SPEICHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
CAROLINAS MEDICAL CENTER-PINEVILLE, 10628 PARK ROAD, CHARLOTTE, NC 28210
(704) 667-1000
(704) 667-0409
Mailing address
10624 BRYONY CT, CHARLOTTE, NC 28277-8751
(704) 708-9017
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
175891
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051738
—
NC
Enumeration date
06/27/2006
Last updated
07/08/2007
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