| Justice Edmond, | |
|
920 Church St N, Concord, NC 28025-2927 | |
| (704) 403-3000 | |
| Not Available |
| Full Name | Justice Edmond |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 920 Church St N, Concord, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023859477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 149635 (North Carolina) | Primary |
| Entity Name | Chs Anesthesia Services Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346649415 PECOS PAC ID: 5799007324 Enrollment ID: O20141209001856 |
| Mailing Address | Practice Location Address |
|---|---|
| Justice Edmond, 3612 Whitehall Green Ln Apt 5109, Charlotte, NC 28273-7303 Ph: (803) 446-0809 | Justice Edmond, 920 Church St N, Concord, NC 28025-2927 Ph: (704) 403-3000 |
Gail Sutton Wooley, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 920 Church St N, Concord, NC 28025 Phone: 704-355-2000 | |
Terri Crockett, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 920 Church St N, Concord, NC 28025 Phone: 704-783-4235 | |
Mary Jean Detchemendy, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 920 Church St N, Concord, NC 28025 Phone: 704-783-4235 Fax: 704-783-2527 | |
Mr. Michael T Roberts, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 920 Church St N, Concord, NC 28025 Phone: 704-783-1622 Fax: 704-783-2527 | |
Janet Yountz Patty, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 920 Church St N, Concord, NC 28025 Phone: 704-783-4235 | |
Virginia Norris Rogers, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 920 Church St N, Concord, NC 28025 Phone: 704-783-4235 |