Provider Demographics
NPI:1881037547
Name:DULLE, NINA LEWIS (CRNA)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:LEWIS
Last Name:DULLE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:LEWIS
Other - Last Name:HOLMANM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:2000 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3764
Mailing Address - Country:US
Mailing Address - Phone:843-881-0100
Mailing Address - Fax:
Practice Address - Street 1:2000 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3764
Practice Address - Country:US
Practice Address - Phone:843-881-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18820367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered