Individual
MIRIAM BOULAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2540 WINDY HILL RD SE, MARIETTA, GA 30067-8605
(470) 644-1274
(470) 644-1119
Mailing address
6791 FAIRWAY RIDGE DR, DOUGLASVILLE, GA 30134-1713
(774) 444-0057
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN250948
GA
Other
Enumeration date
05/16/2024
Last updated
06/12/2024
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