Individual
MRS. JOYCE L MIDDLEBROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
105 PARK PLACE WAY, SUITE 100, CARROLLTON, GA 30117-1960
(770) 832-1494
(770) 830-0990
Mailing address
70 WESTBROOK RD, CARROLLTON, GA 30116-6479
(770) 832-7827
(770) 830-0990
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN029107
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00050701J
—
GA
05
—
000550701L
—
GA
05
—
000550701M
—
GA
05
—
00550701K
—
GA
01
—
214252
BIC
GA
01
—
430071934
RRM PALMETO
GA
01
—
5822654
AETNA
GA
Enumeration date
10/11/2005
Last updated
09/23/2008
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