Individual
MRS. MARY A JUSTYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1900 TEBEAU ST, WAYCROSS, GA 31501-6357
(912) 338-6511
(912) 338-6512
Mailing address
1888 GARDENIA ST, FERNANDINA BEACH, FL 32034-1908
(904) 261-7115
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9183190
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000941817D
—
GA
Enumeration date
04/04/2007
Last updated
11/12/2012
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