Provider Demographics
NPI:1730133083
Name:WARNER, CHRISSIE COVINGTON (CRNA)
Entity Type:Individual
Prefix:
First Name:CHRISSIE
Middle Name:COVINGTON
Last Name:WARNER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:C
Other - Last Name:COVINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:312 METROPOLITAN CT
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-3027
Mailing Address - Country:US
Mailing Address - Phone:334-790-2525
Mailing Address - Fax:
Practice Address - Street 1:616 19TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1528
Practice Address - Country:US
Practice Address - Phone:706-494-4262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2007-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN155086367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA43BBBZFMedicare PIN
GAQ63188Medicare UPIN