MEDICARE: MONICA E BURRELL CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	RN205079	GA

General Provider Information

NPI Number	:	1184978041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA E BURRELL CRNA

Provider Business Mailing Address
First Line	:	2510 ROXBURGH DR
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30076-2455
Country	:	US
Telephone Number	:	770-891-5282
Fax Number	:	770-645-8455

Provider Business Practice Location Address
First Line	:	3333 OLD MILTON PKWY
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30005-4626
Country	:	US
Telephone Number	:	770-645-9181
Fax Number	:	770-645-8455

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2012
Last Update Date	:	12/27/2022

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