Most Relevant Information
Provider Data
| NPI Number: | 1003832643 |
| Provider Name: | LAURA UPHOUSE CRNA |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 045698 |
Most Important Dates
| Enumeration Date: | 07/15/2006 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1640 AIRPORT RD NW
STE 110
KENNESAW
GA
301447038
Practice Location Phone/Fax
| Phone: | 6782022074 |
| Fax: | 7705901442 |
Provider Mailing Location
1984 PEACHTREE RD NW
STE 515
ATLANTA
GA
303095219
Provider Mailing Phone/Fax
| Phone: | 4043511754 |
| Fax: | 4043517121 |