| NPI | 1780112565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDI LYNN LANE Business Owner 479-502-1591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: AR C002958) |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2018-03-17 |