MEDICARE: DEBORAH L NOON 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	RN057610	GA

General Provider Information

NPI Number	:	1659349199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH L NOON CRNA

Provider Business Mailing Address
First Line	:	755 WILKINS RD
Second Line	:
City	:	HAMPTON
State	:	GA
Zip	:	30228-1839
Country	:	US
Telephone Number	:	770-707-1456
Fax Number	:	770-237-1124

Provider Business Practice Location Address
First Line	:	755 WILKINS RD
Second Line	:
City	:	HAMPTON
State	:	GA
Zip	:	30228-1839
Country	:	US
Telephone Number	:	770-707-1456
Fax Number	:	770-237-1124

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

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	08/16/2023

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