Individual
LISA MI BERMUDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
710 CENTER ST, COLUMBUS, GA 31901-1527
(706) 571-1414
Mailing address
6225 STATE HWY 161 STE 200, IRVING, TX 75038-2241
(214) 687-0001
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
174218
TN
163W00000X
Registered Nurse
296832
GA
367500000X
Certified Registered Nurse Anesthetist
23792
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
296832
GA
Other
Enumeration date
11/10/2017
Last updated
06/22/2021
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