Healthcare Provider Details

I. General information

NPI: 1467551101
Provider Name (Legal Business Name): CYNTHIA JANINE HOWLETT CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYNTHIA JANINE FLECK CRNA

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7501 MILLENNIUM DR
FORT SMITH AR
72916-8820
US

IV. Provider business mailing address

7501 MILLENNIUM DR
FORT SMITH AR
72916-8820
US

V. Phone/Fax

Practice location:
  • Phone: 479-420-7965
  • Fax:
Mailing address:
  • Phone: 479-420-7965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberC02607
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: