Individual
GARRET MYHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
601 W MAPLE AVE STE 503, SPRINGDALE, AR 72764-5376
(479) 751-3722
(479) 751-1099
Mailing address
PO BOX 583, LOWELL, AR 72745-0583
(479) 751-3722
(479) 751-1099
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C01576 CRNA
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159362001
—
AR
05
—
200740450A
—
OK
01
—
5Y545
BLUE CROSS BLUE SHIELD
AR
05
—
910053985
—
MO
01
—
P00273455
RR MEDICARE GRP# CD7786
AR
01
—
P02314757
RAILROAD
AR
Enumeration date
05/28/2006
Last updated
06/18/2021
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