Provider Demographics
NPI:1285752279
Name:KREINER, VIRGINIA GARRIS (CRNA)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:GARRIS
Last Name:KREINER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:MICHELLE
Other - Last Name:GARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1910 PAYNE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27295-9054
Mailing Address - Country:US
Mailing Address - Phone:336-765-7753
Mailing Address - Fax:
Practice Address - Street 1:3333 SILAS CREEK PKWY
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-3013
Practice Address - Country:US
Practice Address - Phone:336-718-5000
Practice Address - Fax:336-718-9894
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC170978367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8052978Medicaid
NC8052978Medicaid