Provider Demographics
NPI:1992765473
Name:NITZ, JAMES PETER (CRNA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PETER
Last Name:NITZ
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:128 PEACHTREE LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:ADVANCE
Mailing Address - State:NC
Mailing Address - Zip Code:27006-6782
Mailing Address - Country:US
Mailing Address - Phone:336-998-3396
Mailing Address - Fax:336-998-2889
Practice Address - Street 1:3812 N ELM ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-2596
Practice Address - Country:US
Practice Address - Phone:336-294-1833
Practice Address - Fax:336-998-2889
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC036867367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8050067Medicaid
NC0264UOtherBCBS
NC2286079OtherUNITED HEALTHCARE
NC16186OtherPARTNERS INSURANCE
NC8050067Medicaid