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CLARENCE DAVENPORT UTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
800 TILGHMAN DR, DUNN, NC 28334-5510
(910) 892-1000
(910) 891-6032
Mailing address
3441 CORNELL DR, FAYETTEVILLE, NC 28306-8412
(910) 423-4829

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
020360
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
63157
NC BOARD OF NURSING VERIF
NC
Enumeration date
09/02/2006
Last updated
09/04/2007
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