Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1740217488

Unknown Individual is a healthcare provider. based in Stone mountain, Georgia. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 033314 (GA). The NPI Number for Unknown Individual is 1740217488

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1740217488
Phone
(678) 514-1991
Address
2171 W PARK CT
Deactivation Date
29 May 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 2171 W PARK CT

    SUITE A

    STONE MOUNTAIN, GA 300873555

    Phone: (678) 514-1991

    Fax: (678) 514-1993

    Type: Mailing

  • North Decatur Road, Decatur, DeKalb County, Georgia, 30032, United States

    DECATUR, GA 300335918

    Phone: (404) 501-5265

    Fax: (404) 501-5266

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30087)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1740217488 is assigned to Unknown Individual under the national enumeration system.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where is Unknown Individual's primary listing?
We display Stone Mountain, Georgia because that is what the record indicates for Unknown Individual.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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