Autumn Dale Mahaffey, CRNA
Nurse Anesthetist, Certified Registered in Winston Salem, NC. Individual provider (NPI-1).
NPI number1851660146
StatusActive
Last updated in NPPESDec 15, 2011
Details
- NPI
- 1851660146
- Entity type
- Individual (NPI-1)
- Name
- Autumn Dale Mahaffey
- Credential
- CRNA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 15, 2011
- Last updated
- Dec 15, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 188506 | NC | Yes |
Practice location
145 Kimel Park DrSuite 120
Winston Salem, NC 27103-6984
Phone 336-768-3212 · Fax 336-768-9019
Mailing address
145 Kimel Park DrSuite 120
Winston Salem, NC 27103-6984
Phone 336-768-3212 · Fax 336-768-9019
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