Healthcare Provider Details

I. General information

NPI: 1356417158
Provider Name (Legal Business Name): PATRICIA IRENE FRANCE C.R.N.A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 NORTH 3RD STREET
DARDANELLE AR
72834
US

IV. Provider business mailing address

10154 HIGHWAY 282
MOUNTAINBURG AR
72946-3850
US

V. Phone/Fax

Practice location:
  • Phone: 479-229-4677
  • Fax: 479-229-6161
Mailing address:
  • Phone: 479-369-2769
  • Fax: 479-369-2769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCOO399
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: