Individual
MS. SAMANTHA DENISE BROADWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
901 18TH ST E, TIFTON, GA 31794-3648
(229) 382-7120
Mailing address
901 18TH ST E, TIFTON, GA 31794-3648
(229) 382-7120
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN270598
GA
Other
Enumeration date
06/26/2021
Last updated
07/31/2023
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