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NPI Code Detail

MEDICARE: LAURA ANN REICHWALD CRNA

MEDICARE: LAURA ANN REICHWALD 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 Anesthetist051371GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00245095OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN051371OTHERGAAPN
2N347264OTHERGAWELLCARE
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588601363
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA ANN REICHWALD CRNA
Provider Business Mailing Address
First Line : PO BOX 932925
Second Line :
City : ATLANTA
State : GA
Zip : 31193-2925
Country : US
Telephone Number : 800-364-9216
Fax Number : 423-892-5838
Provider Business Practice Location Address
First Line : 1455 MONTREAL RD
Second Line :
City : TUCKER
State : GA
Zip : 30084-8100
Country : US
Telephone Number : 865-985-7253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2006
Last Update Date : 10/17/2025

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Directions to “ LAURA ANN REICHWALD CRNA” Practice Location

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