Healthcare Provider Details

I. General information

NPI: 1922684182
Provider Name (Legal Business Name): TORIE ALEXANDREA ROBINSON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2021
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 S 56TH ST STE 110
FORT SMITH AR
72903-3710
US

IV. Provider business mailing address

407 WARE RD
GREENWOOD AR
72936-4906
US

V. Phone/Fax

Practice location:
  • Phone: 479-452-1581
  • Fax:
Mailing address:
  • Phone: 501-764-2202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number2018008583
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number215978
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: