Individual
MARY LILLIAN NALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1601 WATSON BLVD, WARNER ROBINS, GA 31093-3431
(478) 329-0051
Mailing address
PO BOX 235019, MONTGOMERY, AL 36123-5019
(334) 279-1450
(334) 279-1660
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN097904
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
369270
STATE MERIT
GA
05
—
668512625A
—
GA
Enumeration date
04/13/2006
Last updated
02/18/2016
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