Provider Demographics
NPI:1871673558
Name:IZLAR, JANICE JONES (CRNA)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:JONES
Last Name:IZLAR
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 1:6 HUNTINGWOOD RETREAT
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31411-2828
Mailing Address - Country:US
Mailing Address - Phone:912-598-1027
Mailing Address - Fax:912-598-9436
Practice Address - Street 1:5361 REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6014
Practice Address - Country:US
Practice Address - Phone:912-355-8000
Practice Address - Fax:912-355-8403
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN062301367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00573801AMedicaid
GA43ZCBTN01Medicare ID - Type Unspecified
GAS19614Medicare UPIN