Individual
SHARON ELIASON MADDREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
118 JENNIFER LN, PERRY, GA 31069-9627
(478) 218-5486
Mailing address
118 JENNIFER LN, PERRY, GA 31069-9627
(478) 218-5486
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28187322A
IN
367500000X
Certified Registered Nurse Anesthetist
RN160682
GA
367500000X
Certified Registered Nurse Anesthetist
RN1655482
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000632178
ANTHEM
IN
05
—
300924600
—
FL
05
—
854895152A
—
GA
Enumeration date
06/12/2006
Last updated
01/27/2010
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