Individual
MR. JAMES W ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
182 LAKE TEHAMA TRL, HOMER, GA 30547-2250
(706) 677-2019
Mailing address
182 LAKE TEHAMA TRL, HOMER, GA 30547-2250
(706) 677-2019
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
032201
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000808244A
—
GA
01
—
LICENSE NUMBER
032201
GA
Enumeration date
06/12/2007
Last updated
08/06/2010
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