Individual
MRS. PHYLLIS BOURN ARTHUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1000 BLYTHE BLVD, CHARLOTTE, NC 28203-5812
(704) 355-2000
Mailing address
4400 GOLF ACRES DR, CHARLOTTE, NC 28208-5968
(704) 512-6428
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
147155
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NAN480
SC MEDICAID
SC
Enumeration date
06/16/2006
Last updated
07/21/2022
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