| NPI | 1922365782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY ANN JOLLEY Director National Credentialing 713-458-4169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 367500000X Nurse Anesthetist, Certified Registered | |
| 367H00000X Anesthesiologist Assistant | |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2024-06-13 |