Healthcare Provider Details

I. General information

NPI: 1740521822
Provider Name (Legal Business Name): ERIN C. STEPHENS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN N. CHANDLER CRNA

II. Dates (important events)

Enumeration Date: 03/14/2013
Last Update Date: 08/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2122 MANCHESTER EXPY
COLUMBUS GA
31904-6878
US

IV. Provider business mailing address

PO BOX 841
COLUMBUS GA
31902-0841
US

V. Phone/Fax

Practice location:
  • Phone: 706-596-4000
  • Fax:
Mailing address:
  • Phone: 334-279-1450
  • Fax: 334-395-4110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN190764
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: