Provider Demographics
NPI:1568633485
Name:CLAXTON, RENE MICHELLE (CRNA)
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:MICHELLE
Last Name:CLAXTON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:RENE
Other - Middle Name:M
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5777 GA HIGHWAY 42 N
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:GA
Mailing Address - Zip Code:31029-4150
Mailing Address - Country:US
Mailing Address - Phone:478-320-2986
Mailing Address - Fax:
Practice Address - Street 1:5777 GA HIGHWAY 42 N
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:GA
Practice Address - Zip Code:31029-4150
Practice Address - Country:US
Practice Address - Phone:478-320-2986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN125932163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse