Del Bagno, Jennifer D

Del Bagno, Jennifer D is an individual health care provider with primary practice located at 1000 Medical Center Blvd , Lawrenceville GA 30046-0000. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Del Bagno, Jennifer D can be contacted via phone (770) 277-3056.

Contact Information

Primary practice address
1000 Medical Center Blvd Lawrenceville GA 30046-0000
Phone: (770) 277-3056
Fax: (855) 204-5244
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R086149 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN086149 Georgia

Profile Details

NPI number 1104852755
LBN Legal business name Del Bagno, Jennifer D
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2006
Last updated Apr 4th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104852755 NPPES
Georgia MEDICAID 00568917A
Georgia MEDICAID 000568917A

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