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Individual

DEANNA HOLLAND POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1900 TEBEAU ST, WAYCROSS, GA 31501-6357
(912) 338-6511
(912) 338-6512
Mailing address
PO BOX 73709, NEWNAN, GA 30271-3709
(770) 251-2060
(678) 854-9235

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN140357
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
534720281B
GA
05
534720281C
GA
01
P00352166
RR MEDICARE INDIVIDUAL
GA
Enumeration date
03/07/2006
Last updated
04/02/2019
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