Individual
MRS. ANNE MCCLUNG MODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1140 HAMMOND DR NE, BUILDING F, SUITE 6100, ATLANTA, GA 30328-5338
(770) 645-9181
(770) 645-8455
Mailing address
3155 N POINT PKWY, BUILDING F, SUITE 100, ALPHARETTA, GA 30005-5481
(770) 645-5117
(770) 645-5120
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN042198
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000885992A
—
GA
Enumeration date
06/28/2006
Last updated
09/28/2009
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