Provider Demographics
NPI:1376965285
Name:ABRAMS, SCARLETT JUSTINE (CRNA)
Entity Type:Individual
Prefix:
First Name:SCARLETT
Middle Name:JUSTINE
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SCARLETT
Other - Middle Name:JUSTINE
Other - Last Name:BLAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 848599
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-8599
Mailing Address - Country:US
Mailing Address - Phone:888-549-1922
Mailing Address - Fax:252-752-2297
Practice Address - Street 1:222 S HERLONG AVE
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1158
Practice Address - Country:US
Practice Address - Phone:803-329-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-11
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC100040367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered