Individual
MONA L GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
104 MALONE ST, SANDERSVILLE, GA 31082-1738
(877) 301-8513
(800) 210-5545
Mailing address
PO BOX 992, SANDERSVILLE, GA 31082-0992
(877) 301-8513
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R32205
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN0251
—
SC
Enumeration date
02/14/2006
Last updated
09/13/2012
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