Healthcare Provider Details

I. General information

NPI: 1629248653
Provider Name (Legal Business Name): CHRISTINE RAMSDEN JACKSON CRNA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2008
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3650 MANSELL RD STE 310
ALPHARETTA GA
30022-3068
US

IV. Provider business mailing address

3650 MANSELL RD STE 310
ALPHARETTA GA
30022-3068
US

V. Phone/Fax

Practice location:
  • Phone: 770-643-5619
  • Fax:
Mailing address:
  • Phone: 770-643-5619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN159431
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-115802
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: