Provider Demographics
NPI:1992281174
Name:MAUCK, KARI BREANNE (CRNA)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:BREANNE
Last Name:MAUCK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 JUTTS CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28771-9347
Mailing Address - Country:US
Mailing Address - Phone:828-506-3578
Mailing Address - Fax:
Practice Address - Street 1:509 BILTMORE AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4601
Practice Address - Country:US
Practice Address - Phone:828-213-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC121771367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered