MEDICARE: JANICE MARIE PLYLER 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	RN072352	GA

Other Identifiers

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

General Provider Information

NPI Number	:	1528032067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANICE MARIE PLYLER CRNA

Provider Business Mailing Address
First Line	:	107 PLANTATION CIR
Second Line	:
City	:	KATHLEEN
State	:	GA
Zip	:	31047-2039
Country	:	US
Telephone Number	:	478-987-7480
Fax Number	:	478-743-6296

Provider Business Practice Location Address
First Line	:	107 PLANTATION CIR
Second Line	:
City	:	KATHLEEN
State	:	GA
Zip	:	31047-2039
Country	:	US
Telephone Number	:	478-987-7480
Fax Number	:	478-743-6296

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	09/20/2023

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