| NPI | 1689129504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN K TANNER C RN A 228-990-4830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AL 1-115992) |
| Enumeration Date | 2016-08-20 |
| Last Update Date | 2016-11-20 |