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Individual

BRENDA D. BUCHANAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1388 WELLBROOK CIRCLE, A, CONYERS, GA 30012-3872
(770) 929-9033
(770) 929-9092
Mailing address
1388 WELLBROOK CIRCLE, A, CONYERS, GA 30012-3872
(770) 929-9033
(770) 929-9092

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN034285
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00782394B
GA
01
430068276
RAILROAD MEDICARE PROV #
GA
Enumeration date
07/06/2006
Last updated
11/02/2011
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