Basic Information
Provider Information
NPI: 1407096597
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RICH
FirstName: CHRISTOPHER
MiddleName: DWIGHT
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 76 PEACHTREE ROAD
Address2: SUITE 300
City: ASHEVILLE
State: NC
PostalCode: 288033505
CountryCode: US
TelephoneNumber: 8282743477
FaxNumber: 8282747407
Practice Location
Address1: 76 PEACHTREE ROAD
Address2: SUITE 300
City: ASHEVILLE
State: NC
PostalCode: 288033505
CountryCode: US
TelephoneNumber: 8282743477
FaxNumber: 8282747407
Other Information
ProviderEnumerationDate: 03/02/2009
LastUpdateDate: 12/11/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X146453NCN Nursing Service ProvidersRegistered Nurse 
367500000X082158NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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