Organization
GLGA ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY NICKELL (CFO)
(706) 623-6699
Entity
Organization
Contact information
Practice address
1250 JESSE JEWELL PKWY SE STE 100, GAINESVILLE, GA 30501-3871
(770) 297-7277
(678) 450-3761
Mailing address
1090 EXPERIMENT STATION RD UNIT 529, WATKINSVILLE, GA 30677-5378
(706) 623-6699
(706) 850-7733
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
10/09/2018
Last updated
05/25/2023
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