Provider Demographics
| NPI: | 1780497198 |
|---|---|
| Name: | CHILDREN'S HEALTHCARE OF ATLANTA, INC |
| Entity type: | Organization |
| Organization Name: | CHILDREN'S HEALTHCARE OF ATLANTA, INC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CRNA |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | BARBARA |
| Authorized Official - Middle Name: | BLAIR |
| Authorized Official - Last Name: | BOWERS |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | BSN,CRNA,DNP |
| Authorized Official - Phone: | 706-593-6475 |
| Mailing Address - Street 1: | 305 VICKERY WAY |
| Mailing Address - Street 2: | |
| Mailing Address - City: | ROSWELL |
| Mailing Address - State: | GA |
| Mailing Address - Zip Code: | 30075-4693 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 706-593-6475 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 2220 N DRUID HILLS RD NE |
| Practice Address - Street 2: | |
| Practice Address - City: | ATLANTA |
| Practice Address - State: | GA |
| Practice Address - Zip Code: | 30329-3117 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 404-785-5437 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2025-01-29 |
| Last Update Date: | 2025-01-29 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | Group - Single Specialty |