Montgomery, Georgia

Montgomery, Georgia is an individual health care provider with primary practice located at 2600 Greenbush St , Lafayette IN 47904-2479. 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. Montgomery, Georgia can be contacted via phone (765) 448-8000.

Contact Information

Primary practice address
2600 Greenbush St Lafayette IN 47904-2479
Phone: (765) 448-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 28167868A Indiana

Profile Details

NPI number 1740245174
LBN Legal business name Montgomery, Georgia
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Feb 1st, 2008 - about 16 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1740245174 NPPES
Indiana Other 000000479774 ANTHEM PROVIDER NUMBER
Indiana Other 9436036 ANTHEM PROVIDER NUMBER

Popular Providers