Individual
CARMEN WAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
2095 HIGHWAY 211 NW # 147-2F, BRASELTON, GA 30517-3402
(678) 789-3057
Mailing address
8108 ROSEFINCH LNDG, HOSCHTON, GA 30548-4244
(678) 789-3057
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
4847
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000
CIGNA. BLUE CROSS, BLUE SHIELD, AETNA
GA
01
—
4847
CERTIFICATION
GA
Enumeration date
08/05/2016
Last updated
08/07/2025
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