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NPI Code Detail

MEDICARE: AMANDA LOUISE GARNER CRNA

MEDICARE:   AMANDA LOUISE GARNER  CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistC02815AR

General Provider Information

NPI Number : 1740509751
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA LOUISE GARNER CRNA
Provider Business Mailing Address
First Line : PO BOX 8099
Second Line :
City : JONESBORO
State : AR
Zip : 72403-8099
Country : US
Telephone Number : 870-932-4211
Fax Number : 870-931-9141
Provider Business Practice Location Address
First Line : 1100 E MATTHEWS AVE
Second Line :
City : JONESBORO
State : AR
Zip : 72401-4314
Country : US
Telephone Number : 870-935-8500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2010
Last Update Date : 06/01/2010

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Directions to “ AMANDA LOUISE GARNER CRNA” Practice Location

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