Individual
IDA M ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
303 PARKWAY DR NE, ATLANTA, GA 30312-1212
(404) 265-4000
Mailing address
5507 VININGS LAKE LN SW, MABLETON, GA 30126-2561
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN031229
GA
Other
Enumeration date
05/31/2006
Last updated
07/08/2007
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