Organization
LBNC ANESTHESIA SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY NICKELL (CFO)
(404) 334-0961
Entity
Organization
Contact information
Practice address
101 W 27TH ST, LUMBERTON, NC 28358-3014
(800) 208-6014
(706) 850-7733
Mailing address
1741 HOG MOUNTAIN RD, WATKINSVILLE, GA 30677-1947
(706) 850-7733
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
10/24/2017
Last updated
06/16/2018
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