Csra Anesthesia
Nurse Anesthetist, Certified Registered in Evans, GA. Organization (NPI-2).
NPI number1346569142
StatusActive
Last updated in NPPESApr 13, 2011
Details
- NPI
- 1346569142
- Entity type
- Organization (NPI-2)
- Legal business name
- Csra Anesthesia
- Organization subpart
- No
- Enumeration date
- May 19, 2010
- Last updated
- Apr 13, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN108812 | GA | Yes |
| 367500000X | Nurse Anesthetist, Certified Registered | 1388 | SC |
Practice location
4480 Sparkleberry CtEvans, GA 30809-4454
Phone 706-868-0131 · Fax 706-210-0771
Mailing address
P O Box 21151Martinez, GA 30917-1551
Phone 706-868-0131 · Fax 706-854-0131
Authorized official
Dean Roger Loss
President
7068681410
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