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NPI Code Detail

MEDICARE: MR. ANDY JAMES CRNA

MEDICARE: MR. ANDY JAMES 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
1163W00000XRegistered NurseRN191954GA
2367500000XCertified Registered Nurse AnesthetistRN191954GA

General Provider Information

NPI Number : 1972883023
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANDY JAMES CRNA
Provider Business Mailing Address
First Line : 923 GRASSMEADE WAY
Second Line :
City : SNELLVILLE
State : GA
Zip : 30078-2116
Country : US
Telephone Number : 404-784-9400
Fax Number :
Provider Business Practice Location Address
First Line : 2175 NORTH RD
Second Line :
City : SNELLVILLE
State : GA
Zip : 30078-2630
Country : US
Telephone Number : 770-979-0900
Fax Number : 770-979-2852
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2011
Last Update Date : 08/14/2022

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