Individual
AMANDA LAVON DELSOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3271 WIMBERLY DR, FAYETTEVILLE, AR 72703-4033
(479) 713-6100
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
(660) 826-4852
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R71833
AR
Other
Enumeration date
05/13/2010
Last updated
05/13/2010
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