Individual
JEROME ANDREW LOTTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4106 COLUMNS DR SE, MARIETTA, GA 30067-9105
(770) 952-6964
Mailing address
4106 COLUMNS DR SE, MARIETTA, GA 30067-9105
(770) 952-6964
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN112885
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN112885
RN LICENSE NUMBER
GA
Enumeration date
03/09/2006
Last updated
07/08/2007
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