Modern Anesthesia Consultants, LLC
Nurse Anesthetist, Certified Registered in Conway, AR. Organization (NPI-2).
NPI number1659976751
StatusActive
Last updated in NPPESDec 4, 2020
Details
- NPI
- 1659976751
- Entity type
- Organization (NPI-2)
- Legal business name
- Modern Anesthesia Consultants, LLC
- Organization subpart
- No
- Enumeration date
- Dec 4, 2020
- Certification date
- Dec 4, 2020
- Last updated
- Dec 4, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | – | – | Yes |
Practice location
810 Merriman StConway, AR 72032-4436
Phone 501-329-3937
Mailing address
Po Box 290342Nashville, TN 37229-0342
Phone 615-620-2320 · Fax 615-620-2323
Authorized official
Crystal D Gibson
Ar/Credentialing Manager
6156202336
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