Susanne Raisor, CRNA | |
1266 Highway 515 S, Jasper, GA 30143-4872 | |
(706) 692-2441 | |
Not Available |
Full Name | Susanne Raisor |
---|---|
Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 1266 Highway 515 S, Jasper, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548256084 | NPI | - | NPPES |
917455 | Other | GA | BCBS PROVIDER NUM |
000547335C | Medicaid | GA | |
P00137037 | Other | GA | RR MEDICARE PROVIDER NUM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | RN052516 (Georgia) | Primary |
Entity Name | Mountainside Anesthesia Consultants, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1346327152 PECOS PAC ID: 2365430899 Enrollment ID: O20040504000685 |
Entity Name | Mak Anesthesia Holdings, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1912452939 PECOS PAC ID: 4284917204 Enrollment ID: O20170216001563 |
Entity Name | Fortis Health, Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1659960276 PECOS PAC ID: 8325446305 Enrollment ID: O20211005002270 |
Mailing Address | Practice Location Address |
---|---|
Susanne Raisor, CRNA 744 Noah Dr, Suite 113-315, Jasper, GA 30143-8705 Ph: (706) 301-1098 | Susanne Raisor, CRNA 1266 Highway 515 S, Jasper, GA 30143-4872 Ph: (706) 692-2441 |
James Wesley Conner, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1266 Highway 515 S, Jasper, GA 30143 Phone: 706-455-7737 | |
Janice Meeks, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 515 Highway 515 S, Jasper, GA 30143 Phone: 706-692-2441 | |
Jeffrey I Kalish, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 744 Noah Drive, Suite 113-315, Jasper, GA 30143 Phone: 706-301-1098 Fax: 706-301-9151 |