CLEOPATRA WALLACE

MACON, GA
NPI1679959852
Former NameCLEOPATRA W. SHIRLEY
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: GA  RN181636)
Additional Taxonomies163W00000X Registered Nurse
(Licence: GA  RN181636)
Enumeration Date2015-08-10
Last Update Date2018-03-12
Business Address
CLEOPATRA WALLACE CRNA
777 HEMLOCK ST
MACON, GA 31201-2102
Phone number: 478-633-2147
Mailing Address
CLEOPATRA WALLACE CRNA
PO BOX 551420
FORT LAUDERDALE, FL 33355-1420
Phone number: 800-243-3839