Organization
ELEGANCE ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRBY KITCHENS (MANAGER)
(240) 469-2179
Entity
Organization
Contact information
Practice address
577 MULBERRY ST STE 110, MACON, GA 31201-8220
(240) 469-2179
Mailing address
PO BOX 850001 DEPT 740F, ORLANDO, FL 32885-0740
(240) 469-2179
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
05/14/2019
Last updated
07/01/2020
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