Provider Demographics
NPI:1184680894
Name:ALLAN, JOSIAN (CRNA)
Entity Type:Individual
Prefix:
First Name:JOSIAN
Middle Name:
Last Name:ALLAN
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 1:2600 ESSEX LN SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-7854
Mailing Address - Country:US
Mailing Address - Phone:404-228-2906
Mailing Address - Fax:404-228-2906
Practice Address - Street 1:2600 ESSEX LN SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-7854
Practice Address - Country:US
Practice Address - Phone:404-228-2906
Practice Address - Fax:404-228-2906
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN13088367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
RN13088OtherLICENSE #
GA383203853CMedicaid
Q39782Medicare UPIN
RN13088OtherLICENSE #