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Individual

WILLIAM RENO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
FORT DEFIANCE INDIAN HOSPITAL, CORNER OR RT N12 & N7, FORT DEFIANCE, AZ 86504
(928) 729-8741
Mailing address
PO BOX 693, BISBEE, AZ 85603-0693

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN113844
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
41-209-00153
RN/CRNA LICENSE
IL
Enumeration date
11/03/2006
Last updated
07/08/2007
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