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Individual

KATELYN E LONGACRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1300 RIDENOUR BLVD NW STE 300, KENNESAW, GA 30152-4402
(770) 702-1806
(770) 693-0810
Mailing address
1300 RIDENOUR BLVD NW STE 300, KENNESAW, GA 30152-4402
(770) 702-1806
(770) 693-0810

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN311144
GA
367500000X
Certified Registered Nurse Anesthetist
RN9292268
FL

Other

Enumeration date
05/17/2013
Last updated
12/08/2023
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