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Individual

MICHELLE S WOMBLE CUSTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
65 WADDELL RD, WOODBURY, GA 30293-4008
(706) 573-6769
(706) 553-3525
Mailing address
80 NEWNAN STATION DR, STE A, NEWNAN, GA 30265-3194
(770) 814-6011

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN149265
GA

Other

Enumeration date
11/21/2006
Last updated
02/18/2021
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