Provider Demographics
NPI:1184978041
Name:BURRELL, MONICA E (CRNA)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:E
Last Name:BURRELL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:E
Other - Last Name:BUFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2510 ROXBURGH DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-2455
Mailing Address - Country:US
Mailing Address - Phone:770-891-5282
Mailing Address - Fax:770-645-8455
Practice Address - Street 1:3333 OLD MILTON PKWY
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4626
Practice Address - Country:US
Practice Address - Phone:770-645-9181
Practice Address - Fax:770-645-8455
Is Sole Proprietor?:No
Enumeration Date:2012-10-31
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN205079367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered