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Contact Information

SELENE R FORRESTALL, CRNA
9263 MEDICAL PLAZA DR STE E
CHARLESTON, SC29406
 Phone: 843-572-1228
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
Indicates primary specialty

NPI Profile & details for SELENE R FORRESTALL · (Female)

NPI # 1013078013
Status Active
Credentials CRNA (Certified Registered Nurse Anesthetist)
Entity Individual
Enumeration date 12/13/2006
Last updated 01/09/2019 - About 9 months ago
Sole proprietor 1 No
Identifiers
  • MA License # 254742
  • SC License # 22437
Hospital affiliation(s)
  • MOUNT AUBURN HOSPITAL - (Acute Care)
    330 MOUNT AUBURN STREET
    CAMBRIDGE, MA 02138
  • TRIDENT MEDICAL CENTER - (Acute Care)
    9330 MEDICAL PLAZA DR
    CHARLESTON, SC 29406
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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