| NPI | 1285859009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REX D WAGGONER President 479-751-6352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C00272) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |