Individual
MISS TRACY LYNN DAVENPORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
Mailing address
191 PLANTATION DR, MAYFLOWER, AR 72106-8420
(501) 442-1640
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C02646 CRNA
AR
Other
Enumeration date
12/02/2006
Last updated
11/02/2007
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