Individual
ANNA WISTED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3000 HOSPITAL BLVD, ROSWELL, GA 30076-4915
(678) 772-7577
Mailing address
16 REVIVAL ST, ROSWELL, GA 30075-4801
(678) 772-7577
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN254819
GA
Other
Enumeration date
09/15/2022
Last updated
05/14/2024
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