Healthcare Provider Details

I. General information

NPI: 1851780449
Provider Name (Legal Business Name): ANNA-MARIE THARP CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA-MARIE RIGGINS

II. Dates (important events)

Enumeration Date: 01/20/2015
Last Update Date: 08/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1613 HARRISON PKWY SUITE 200
SUNRISE FL
33323-2896
US

IV. Provider business mailing address

1500 S MAIN ST
FORT WORTH TX
76104-4917
US

V. Phone/Fax

Practice location:
  • Phone: 954-838-2371
  • Fax:
Mailing address:
  • Phone: 954-838-2371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP127257
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: