Healthcare Provider Details

I. General information

NPI: 1427449842
Provider Name (Legal Business Name): ANITA A GARLAND CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2015
Last Update Date: 02/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5665 PEACHTREE DUNWOODY RD
ATLANTA GA
30342-1764
US

IV. Provider business mailing address

PO BOX 102163
ATLANTA GA
30368-2163
US

V. Phone/Fax

Practice location:
  • Phone: 706-543-3449
  • Fax: 706-543-5744
Mailing address:
  • Phone: 706-543-3449
  • Fax: 706-543-5744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN170257
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: