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TERRA LYNN KLOTH CRNA
>> Nurse Anesthetist, Certified Registered >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1285010611
Individual Registrant: TERRA LYNN KLOTH CRNA
Gender: F
Not Sole Proprietor
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: --
Tel: 608-217-5503 Fax: --
Contact information for business:
6451 COME ABOUT WAY AWENDAW, SC 29429-6022 US
Tel: 608-217-5503 Fax: --
Tel: 608-217-5503 Fax: --
Registration Information:
NPI: 1285010611
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 367500000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Anesthetist, Certified Registered | SC | 215418 |
| Y | 367500000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Anesthetist, Certified Registered | SC | 19776 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
