Individual
LACEY LISS CHAVARRIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
601 N ELM ST, HIGH POINT, NC 27262-4331
(336) 878-6000
(336) 878-6010
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 878-6000
(336) 878-6010
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
181589
NC
367500000X
Certified Registered Nurse Anesthetist
078220
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
3465
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8053006
—
NC
Enumeration date
09/11/2007
Last updated
05/27/2025
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