Healthcare Provider Details

I. General information

NPI: 1851748263
Provider Name (Legal Business Name): ADRIAN DAYNE GODWIN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 W 3RD AVE
ALBANY GA
31701-1943
US

IV. Provider business mailing address

500 W 3RD AVE STE 101
ALBANY GA
31701-1985
US

V. Phone/Fax

Practice location:
  • Phone: 229-312-1000
  • Fax:
Mailing address:
  • Phone: 229-312-5800
  • Fax: 229-312-5853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN213990
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN9364660
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: