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Individual

SHAWN LEDFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
11 UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2615
(770) 478-9877
(770) 478-2908
Mailing address
405 ARROWHEAD BLVD, SUITE C, JONESBORO, GA 30236-1254
(770) 478-9877
(770) 478-2908

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN126019
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN126019
GA

Other

Enumeration date
12/16/2010
Last updated
02/03/2011
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