Healthcare Provider Details

I. General information

NPI: 1568633485
Provider Name (Legal Business Name): RENE MICHELLE CLAXTON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RENE M KNIGHT

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5777 GA HIGHWAY 42 N
FORSYTH GA
31029-4150
US

IV. Provider business mailing address

5777 GA HIGHWAY 42 N
FORSYTH GA
31029-4150
US

V. Phone/Fax

Practice location:
  • Phone: 478-320-2986
  • Fax:
Mailing address:
  • Phone: 478-320-2986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN125932
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN125932
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: