Individual
CHRISTINE LOUISE DEATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10030 GILEAD RD, HUNTERSVILLE, NC 28078-7545
(704) 316-4875
Mailing address
20207 RAINBOW DRIVE, CORNELIUS, NC 28031
(724) 513-2657
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN536140
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101222178
—
PA
05
—
AN0174
—
SC
Enumeration date
02/07/2006
Last updated
05/06/2013
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