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Individual

TINA MARIE SHAHEEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
350 HOSPITAL DR, MACON, GA 31217-3838
(478) 746-7577
Mailing address
PO BOX 551420, FORT LAUDERDALE, FL 33355-1420
(800) 243-3839
(855) 851-4405

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN052904
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
699559842B
GA
01
949202
BCBS
GA
Enumeration date
04/19/2006
Last updated
11/29/2023
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