Individual
STACY V. SENNETT PEEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
501 REDMOND RD NW, ANESTHESIOLOGY DEPARTMENT, ROME, GA 30165-1415
(706) 291-0291
Mailing address
600 CAVE SPRING ROAD, CEDARTOWN, GA 30165
(770) 748-0292
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
093906
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000618857F
—
GA
05
—
000618857G
—
GA
01
—
P00211518
RAILROAD MEDICARE
GA
Enumeration date
05/31/2006
Last updated
08/04/2008
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