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General NPI Number Information
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NPI Number | 1144525940
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Entity Type | Individual
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Provider Name | KERI ANN PAULK CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 02/15/2013
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Provider Practice Location Address
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Address Line | 901 GRIFFIN AVE
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City | EASTMAN
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State | GA
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Zip | 31023-6720
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Country | US
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Telephone | 478-448-4020
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Fax | 478-448-4020
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Provider Business Mailing Address
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Address Line | 62 SUGAR CREEK LN
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City | EASTMAN
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State | GA
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Zip | 31023-3784
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Country | US
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Telephone | 229-646-1348
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP9236806
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN212553
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License Number State | GA
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