Individual
MARY MCMINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6119 MIDTOWN AVE STE 101, LITTLE ROCK, AR 72205-5316
(501) 404-8007
(501) 904-3620
Mailing address
800 FAIR PARK BLVD, LITTLE ROCK, AR 72204-1720
(501) 404-8007
(501) 904-3620
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R100683
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
214894
AR
Other
Enumeration date
01/20/2021
Last updated
01/05/2023
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