Black River Anesthesia, Plc
Nurse Anesthetist, Certified Registered in Pocahontas, AR. Organization (NPI-2).
NPI number1124174271
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1124174271
- Entity type
- Organization (NPI-2)
- Legal business name
- Black River Anesthesia, Plc
- Organization subpart
- No
- Enumeration date
- Jan 25, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | C00474 CRNA | AR | Yes |
Practice location
2801 Medical Center DrPocahontas, AR 72455-9436
Phone 870-972-8053 · Fax 870-972-8053
Mailing address
Po Box 1288Jonesboro, AR 72403-1288
Phone 870-972-8053 · Fax 870-972-8053
Authorized official
Susan Lynn Wyatt
Office Manager
8709728053
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