Provider Demographics
NPI:1023684966
Name:SANDKUHLER, CAROLINE LEWIS (CRNA)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:LEWIS
Last Name:SANDKUHLER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:CLAIRE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3288 BANNOCK DR
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-8315
Mailing Address - Country:US
Mailing Address - Phone:803-554-4130
Mailing Address - Fax:
Practice Address - Street 1:1000 BLYTHE BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5812
Practice Address - Country:US
Practice Address - Phone:803-554-4130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6893367500000X
SC240567163W00000X
SC141224367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZCW877438380325OtherBCBS