Provider Demographics
NPI:1447231972
Name:ENSMINGER, ANNE FREW (CRNA)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:FREW
Last Name:ENSMINGER
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:PO BOX 116276
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-6276
Mailing Address - Country:US
Mailing Address - Phone:770-232-8611
Mailing Address - Fax:770-232-8618
Practice Address - Street 1:2131 FOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-7024
Practice Address - Country:US
Practice Address - Phone:770-979-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAR081138367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAR11633Medicare UPIN
GA43ZCBGM01Medicare PIN