| NPI | 1194796607 |
|---|---|
| Doing Business As | PROVIDENCE HOSPITAL CRNAS |
| Entity Type | Organization |
| Authorized Contact | JHO R. OUTLAW Executive Director 803-454-2600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2015-05-27 |