Healthcare Provider Details

I. General information

NPI: 1508090614
Provider Name (Legal Business Name): EMILY GEER NICHOLS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2009
Last Update Date: 12/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11705 MERCY BLVD
SAVANNAH GA
31419-1711
US

IV. Provider business mailing address

6605 ABERCORN ST SUITE 108
SAVANNAH GA
31405-5815
US

V. Phone/Fax

Practice location:
  • Phone: 912-819-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN171930
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: