Individual
KERI ANN PAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
901 GRIFFIN AVE, EASTMAN, GA 31023-6720
(478) 448-4020
(478) 448-4020
Mailing address
62 SUGAR CREEK LN, EASTMAN, GA 31023-3784
(229) 646-1348
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
ARNP9236806
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
RN212553
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003105271A
—
GA
05
—
0031395-00
—
FL
Enumeration date
01/26/2011
Last updated
02/15/2013
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