Healthcare Provider Details

I. General information

NPI: 1982029740
Provider Name (Legal Business Name): RACHEL SPAHN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2710 S RIFE MEDICAL LN
ROGERS AR
72758-1452
US

IV. Provider business mailing address

4427 W SWEETGUM LN
FAYETTEVILLE AR
72704-7916
US

V. Phone/Fax

Practice location:
  • Phone: 913-642-4900
  • Fax: 913-381-0979
Mailing address:
  • Phone: 479-353-0446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number093599
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: