Individual
SANDY LEEANN MARSHALL RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8954 HOSPITAL DR, DOUGLASVILLE, GA 30134-2272
(770) 920-6413
(678) 838-2532
Mailing address
PO BOX 1950, DOUGLASVILLE, GA 30133-1950
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN150781
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000903548B
—
GA
05
—
491431789A
—
GA
Enumeration date
11/17/2005
Last updated
02/18/2010
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