Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KEANDREA BACON
Active Sole ProprietorKEANDREA BACON is a Certified Nurse Anesthetist (CRNA) healthcare provider located in ELLENWOOD, Georgia. NPI 1619712676 is currently active in the NPPES registry. Verify at CMS.
Certified Nurse Anesthetist (CRNA) · ELLENWOOD, GA
Registration Details
- NPI Number
- 1619712676
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 1, 2024 (2.1640918818165 yrs)
- Last Updated
- Sep 23, 2025
- Licenses
-
CRNA233963 (GA)RN233963 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
120 WHIRLAWAY DRELLENWOOD, GA, 302943259Browse GA providers · Browse ZIP 30294
- Phone
- 4044443887
- Primary Specialty
-
Certified Nurse Anesthetist (CRNA)
367500000X
- Additional Specialty
- Registered Nurse
Other Certified Nurse Anesthetist (CRNA) Providers in ELLENWOOD, GA
| Name | Credential | NPI |
|---|---|---|
| KAMICA ROSS HATCHETT | CRNA | 1336507185 |
| DR. GABRIEL SALAMI | CRNA | 1881423465 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.