Provider Demographics
NPI:1003802737
Name:HANLEY, SHEILA M (CRNA)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:M
Last Name:HANLEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6335 HOSPITAL PKWY STE 111
Mailing Address - Street 2:ATTN: CREDENTIALING DEPT.
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-1550
Mailing Address - Country:US
Mailing Address - Phone:404-778-8311
Mailing Address - Fax:770-495-1585
Practice Address - Street 1:6335 HOSPITAL PKWY STE 111
Practice Address - Street 2:ATTN: CREDENTIALING DEPT.
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-1550
Practice Address - Country:US
Practice Address - Phone:404-778-8311
Practice Address - Fax:770-495-1585
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN096505367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000549766JMedicaid
GA000549766IMedicaid
GA000549766AMedicaid
GA000549766IMedicaid
GA000549766JMedicaid
GA430025885Medicare PIN