Individual
HEATH FARMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
901 18TH ST E, TIFTON, GA 31794-3648
(229) 353-6124
(229) 353-7722
Mailing address
901 18TH ST E, TIFTON, GA 31794-3648
(229) 353-6124
(229) 353-7722
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN197658
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN197658
STATE LICENSE
GA
Enumeration date
04/02/2013
Last updated
04/02/2013
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