Individual provider · NPI-1

Eric J Ark, CRNA

Nurse Anesthetist, Certified Registered · Madison, WI

NPI number1639525629
StatusActive
Last updated in NPPESJan 7, 2020

Details

NPI
1639525629
Entity type
Individual (NPI-1)
Name
Eric J Ark
Credential
CRNA
Sex
Male
Sole proprietor
No
Enumeration date
May 9, 2016
Certification date
Jan 7, 2020
Last updated
Jan 7, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified Registered154670WIYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

600 Highland Ave
Madison, WI 53792-0001

Phone 608-263-8100 · Fax 608-263-8111

Mailing address

7974 Uw Health Ct
Middleton, WI 53562-5531

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