Provider Demographics
NPI:1891874939
Name:ADAMS, CORNELIA (CRNA)
Entity Type:Individual
Prefix:
First Name:CORNELIA
Middle Name:
Last Name:ADAMS
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 8846
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27419-0846
Mailing Address - Country:US
Mailing Address - Phone:336-553-1659
Mailing Address - Fax:
Practice Address - Street 1:4280 N VALDOSTA RD
Practice Address - Street 2:DEPT OF ANESTHESIA
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-6814
Practice Address - Country:US
Practice Address - Phone:229-671-2066
Practice Address - Fax:336-553-3994
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN088534367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered