Individual
LAURA COTHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1035 RED BUD RD NE, CALHOUN, GA 30701-6010
(706) 624-5079
(706) 879-5841
Mailing address
PO BOX 12938, CALHOUN, GA 30703-7013
(706) 602-7800
(706) 879-5843
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
111900
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP4720
GRP PTAN
GA
Enumeration date
09/19/2016
Last updated
10/21/2016
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