Provider Demographics
NPI:1407993967
Name:WEISSGERBER, ALICIA J (CRNA)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:J
Last Name:WEISSGERBER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6335 HOSPITAL PKWY STE LL17
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-1549
Mailing Address - Country:US
Mailing Address - Phone:404-778-8323
Mailing Address - Fax:770-495-1585
Practice Address - Street 1:6335 HOSPITAL PKWY STE LL17
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-1549
Practice Address - Country:US
Practice Address - Phone:404-778-8323
Practice Address - Fax:770-495-1585
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC228034367500000X
GARN152736367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered