Individual
SHELLY LAUREN HERETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1200 MEMORIAL DR, DALTON, GA 30720-2529
(706) 272-6000
(423) 602-8401
Mailing address
385 DAVIS RIDGE RD, RINGGOLD, GA 30736-5900
(423) 645-0902
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN200088
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN21838
TN
367500000X
Certified Registered Nurse Anesthetist
RN213029
GA
Other
Enumeration date
07/19/2016
Last updated
12/03/2025
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