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TERRA LYNN KLOTH CRNA

>> Nurse Anesthetist, Certified Registered >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1285010611

Individual Registrant:
 TERRA LYNN  KLOTH CRNA
Gender: F
Not Sole Proprietor

Location and contact information for practice:
6451 COME ABOUT WAY  AWENDAW, SC 29429-6022 US
Tel: 608-217-5503  Fax: --

Contact information for business:
6451 COME ABOUT WAY  AWENDAW, SC 29429-6022 US
Tel: 608-217-5503  Fax: --

Registration Information:
NPI: 1285010611
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N367500000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Anesthetist, Certified Registered
SC215418
Y367500000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Anesthetist, Certified Registered
SC19776

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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