Provider Demographics
NPI:1811131394
Name:VEAL, JERRY NORRIS JR (CRNA)
Entity type:Individual
Prefix:MR
First Name:JERRY
Middle Name:NORRIS
Last Name:VEAL
Suffix:JR
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 81472
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30608-1472
Mailing Address - Country:US
Mailing Address - Phone:706-353-1301
Mailing Address - Fax:706-353-1510
Practice Address - Street 1:8771 MACON HWY
Practice Address - Street 2:SUITE A
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-5224
Practice Address - Country:US
Practice Address - Phone:706-353-1301
Practice Address - Fax:706-353-1510
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-28
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN124545 CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered