Provider Demographics
NPI:1629072582
Name:DAINTY, THOMAS S (CRNA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:S
Last Name:DAINTY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 SYLVAN ACRES RD
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28785-9471
Mailing Address - Country:US
Mailing Address - Phone:828-400-4459
Mailing Address - Fax:
Practice Address - Street 1:76 PEACHTREE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3131
Practice Address - Country:US
Practice Address - Phone:828-771-5215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001153014163W00000X
VA153014367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8933545Medicaid