Healthcare Provider Details

I. General information

NPI: 1205078078
Provider Name (Legal Business Name): FRANCES TUCKER AUSTIN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2009
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1765 OLD WEST BROAD ST
ATHENS GA
30606-2853
US

IV. Provider business mailing address

328 LYNDON AVE
ATHENS GA
30601-1923
US

V. Phone/Fax

Practice location:
  • Phone: 706-549-1663
  • Fax:
Mailing address:
  • Phone: 706-286-0742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRNA233009
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number087921-23
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN159789
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: