Individual
GLORIA C YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1120 15TH ST, RM 2144, AUGUSTA, GA 30912-0004
(706) 721-3873
(706) 721-7763
Mailing address
PO BOX 28068, CHATTANOOGA, TN 37424-8068
(877) 899-1033
(423) 892-5838
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN117764
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
237753030A
—
GA
05
—
237753030B
—
GA
01
—
339354
WELLCARE CMO
GA
01
—
550789920
TRICARE
GA
05
—
GAN608
—
SC
01
—
P00375230
RRMEDICARE
GA
Enumeration date
06/05/2006
Last updated
06/15/2008
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