Individual
SUSAN GHODRAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2655 NORTHWINDS PKWY, ALPHARETTA, GA 30009-2280
(678) 690-7804
Mailing address
1788 N PIERCE ST APT 508, ARLINGTON, VA 22209-2525
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001260445
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0001260445
VA
Other
Enumeration date
12/28/2021
Last updated
05/16/2022
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