Healthcare Provider Details

I. General information

NPI: 1417966599
Provider Name (Legal Business Name): JO T SINEATH CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 CLIFTON RD NE 3B ANESTHESIOLOGY
ATLANTA GA
30322-1059
US

IV. Provider business mailing address

5265 SILVER CREEK DR SW
LILBURN GA
30047-5359
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-4852
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN061613
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: