Healthcare Provider Details

I. General information

NPI: 1154057008
Provider Name (Legal Business Name): ALANA LEA VARGAS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2022
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 ELLSWORTH RD
FORT SMITH AR
72903-2661
US

IV. Provider business mailing address

6301 ELLSWORTH RD
FORT SMITH AR
72903-2661
US

V. Phone/Fax

Practice location:
  • Phone: 760-521-1872
  • Fax:
Mailing address:
  • Phone: 760-521-1872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number223937
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number220020
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3-002644
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2018025989
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11039118
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: