Healthcare Provider Details

I. General information

NPI: 1609825751
Provider Name (Legal Business Name): YOLANDA PEREZ DUNCAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 JOHNSON FERRY RD SCOTTISH RITE DEPT OF ANES
ATLANTA GA
30342
US

IV. Provider business mailing address

1001 JOHNSON FERRY RD SCOTTISH RITE DEPT OF ANES
ATLANTA GA
30342
US

V. Phone/Fax

Practice location:
  • Phone: 404-785-2008
  • Fax: 404-785-4496
Mailing address:
  • Phone: 404-785-5932
  • Fax: 404-785-5932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR132368
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: