Individual
DARA EDGHILL-ODLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
815 SHADY BANK CT, MACON, GA 31220-5379
(347) 768-3628
Mailing address
815 SHADY BANK CT, MACON, GA 31220-5379
(347) 768-3628
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN220966
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN220966
GA
Other
Enumeration date
09/23/2016
Last updated
02/14/2017
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