Individual
CHARLES J FETNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
209 N CUTHBERT ST, COLQUITT, GA 39837-3518
(229) 758-6062
Mailing address
2066 THREE NOTCH RD, BLAKELY, GA 39823-3015
(229) 758-6062
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN063272
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00546851C
—
GA
Enumeration date
11/07/2006
Last updated
07/08/2007
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