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General NPI Number Information
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NPI Number | 1295989028
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Entity Type | Individual
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Provider Name | MARLA AUTRY JONES CRNA
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Gender | Female
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Dates
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Enumeration Date | 11/06/2008
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Last Update Date | 11/10/2011
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Provider Practice Location Address
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Address Line | 3079 PEACHTREE INDUSTRIAL BLVD ANESTHESIA DEPT.
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City | DULUTH
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State | GA
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Zip | 30097-2215
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Country | US
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Telephone | 800-945-6133
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Fax |
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Provider Business Mailing Address
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Address Line | 101 JOYNER DR
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City | THOMASTON
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State | GA
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Zip | 30286-5448
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Country | US
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Telephone | 706-647-7501
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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 | RN072353
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License Number State | GA
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