NPI 1003136862

Paul Derek Street, CRNA

Practitioner Certified Registered Nurse Anesthetist Greenville, SC

Practice location

Address: 7 Independence PT STE 300, Greenville, SC 29615-4569
Phone: (864) 522-3700
Fax: (864) 522-3705
Mailing address: 300 E McBee Ave Fl 4, Greenville, SC 29601-2842

Registered specialties

Certified Registered Nurse Anesthetist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence APRN4210 (SC)

Other Nurse Anesthetist, Certified Registered providers in South Carolina →

Registry record

NPI: 1003136862
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Jun 2010
Record last updated: 28 Jan 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.