Provider Demographics
NPI:1326201674
Name:DEMPSEY, ELISABETH LYNN (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:ELISABETH
Middle Name:LYNN
Last Name:DEMPSEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MRS
Other - First Name:ELISABETH
Other - Middle Name:LYNN
Other - Last Name:DEMPSEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:189 PROFESSIONAL COURT SUITE 106
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30703-0128
Mailing Address - Country:US
Mailing Address - Phone:706-602-9995
Mailing Address - Fax:706-624-0271
Practice Address - Street 1:1035 RED BUD RD NE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-6008
Practice Address - Country:US
Practice Address - Phone:706-602-9995
Practice Address - Fax:706-624-0271
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN143389367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA300029150AOtherMEDICAID GRP NUMBER
GA780016937AMedicaid
GACM5659OtherRAILROAD GRP NUMBER
GAGRP332OtherMEDICARE GRP NUMBER