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General NPI Number Information
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NPI Number | 1588601363
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Entity Type | Individual
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Provider Name | LAURA ANN REICHWALD CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 1455 MONTREAL RD
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City | TUCKER
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State | GA
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Zip | 30084-8100
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Country | US
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Telephone | 865-985-7253
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 932925
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City | ATLANTA
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State | GA
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Zip | 31193-2925
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Country | US
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Telephone | 800-364-9216
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Fax | 423-892-5838
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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 | 051371
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License Number State | GA
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