Healthcare Provider Details
I. General information
NPI: 1568792331
Provider Name (Legal Business Name): JANET L HEATH CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/30/2009
Last Update Date: 03/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11705 MERCY BLVD
SAVANNAH GA
31419-1711
US
IV. Provider business mailing address
175 BALD CYPRESS LN
BLOOMINGDALE GA
31302-9317
US
V. Phone/Fax
- Phone: 912-354-5357
- Fax:
- Phone: 205-936-3924
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | RN206630 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: