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General NPI Number Information
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NPI Number | 1861444101
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Entity Type | Individual
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Provider Name | STEPHEN R SPIRES CRNA
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 815 S 10TH ST ELITE ANES. - CREDENTIALING
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City | LEESVILLE
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State | LA
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Zip | 71446-4611
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Country | US
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Telephone | 337-392-5088
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Fax | 337-392-4982
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Provider Business Mailing Address
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Address Line | 6000 BOCAGE DR
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City | ALEXANDRIA
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State | LA
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Zip | 71303-2191
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Country | US
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Telephone | 318-419-0756
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Fax | 337-392-4982
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN099590-AP04371
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License Number State | LA
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