MEDICARE: ROSE M. SYNSMIR 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	RN174648	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	:	1992792741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSE M. SYNSMIR CRNA

Provider Business Mailing Address
First Line	:	11840 DEVON DOWNS TRL
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30005-7287
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1170 CLEVELAND AVE
Second Line	:	ANESTHESIA DEPARTMENT
City	:	EAST POINT
State	:	GA
Zip	:	30344-3615
Country	:	US
Telephone Number	:	770-466-1700
Fax Number	:

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

Provider Enumeration Date	:	10/05/2005
Last Update Date	:	12/08/2009

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