Most Relevant Information
Provider Data
| NPI Number: | 1003198268 |
| Provider Name: | COLE BURGESS CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | RN192175 |
Most Important Dates
| Enumeration Date: | 09/14/2011 |
| Last Updated: | 09/14/2011 |
Provider Practice Location
901 18TH ST E
TIFTON
GA
317943648
Practice Location Phone/Fax
| Phone: | 2293536124 |
| Fax: | 2293537722 |
Provider Mailing Location
901 18TH ST E
TIFTON
GA
317943648
Provider Mailing Phone/Fax
| Phone: | 2293536124 |
| Fax: | 2293537722 |