Provider Demographics
NPI:1497181572
Name:NMDA CRNA SERVICES
Entity Type:Organization
Organization Name:NMDA CRNA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JARED
Authorized Official - Middle Name:
Authorized Official - Last Name:DERANEY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:866-458-0036
Mailing Address - Street 1:PO BOX 6377
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31095-6377
Mailing Address - Country:US
Mailing Address - Phone:866-458-0036
Mailing Address - Fax:478-974-0110
Practice Address - Street 1:4080 MCGINNIS FERRY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-3948
Practice Address - Country:US
Practice Address - Phone:888-872-8088
Practice Address - Fax:478-974-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty