Provider Demographics
NPI:1548263510
Name:FOX, LAUREL K (CRNA)
Entity type:Individual
Prefix:MRS
First Name:LAUREL
Middle Name:K
Last Name:FOX
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14 CHADWICK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7464
Mailing Address - Country:US
Mailing Address - Phone:843-766-7819
Mailing Address - Fax:843-720-8449
Practice Address - Street 1:125 DOUGHTY ST
Practice Address - Street 2:STE 430
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5741
Practice Address - Country:US
Practice Address - Phone:843-720-8448
Practice Address - Fax:843-720-8449
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC25345367500000X
TX37462367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered