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NPI Code Detail

MEDICARE: TERESA LAWHORN GAY CRNA

MEDICARE: TERESA LAWHORN GAY 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
1367500000XCertified Registered Nurse AnesthetistRN096610GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2430076995OTHERGAMCRB RAILROAD

General Provider Information

NPI Number : 1215901277
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA LAWHORN GAY CRNA
Provider Business Mailing Address
First Line : PO BOX 1707
Second Line :
City : MILLEDGEVILLE
State : GA
Zip : 31059-1707
Country : US
Telephone Number : 478-457-2036
Fax Number : 478-457-2042
Provider Business Practice Location Address
First Line : 821 N COBB ST
Second Line :
City : MILLEDGEVILLE
State : GA
Zip : 31061-2343
Country : US
Telephone Number : 478-457-2036
Fax Number : 478-457-2042
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2006
Last Update Date : 10/12/2010

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