Individual
KEVIN BRAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3651 WHEELER RD, AUGUSTA, GA 30909-6521
(844) 810-4299
Mailing address
2303 LIONS GATE DR, AUGUSTA, GA 30909-2193
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN231685
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN231685
GA
Other
Enumeration date
01/07/2019
Last updated
01/24/2020
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