Individual
MR. KATHY T CRYSEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-3069
Mailing address
1217 ARBORETUM DR, LEWISVILLE, NC 27023-8658
(336) 201-7863
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
072701
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051552
—
NC
01
—
P00299560
R MEDICARE
NC
Enumeration date
12/14/2005
Last updated
08/30/2007
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