Healthcare Provider Details

I. General information

NPI: 1932590759
Provider Name (Legal Business Name): ALEXANDRA RAY BROWN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRA KRYSTEN RAY

II. Dates (important events)

Enumeration Date: 02/16/2015
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST
AUGUSTA GA
30912-6043
US

IV. Provider business mailing address

437 BRIGHAM TRL
AUGUSTA GA
30909-6043
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number105205
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN210247
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number6114
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: