Individual
TERRENCE CHRISTOPHER DIEBOLD
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3120 PRESTWICK CIR, JONESBORO, AR 72401-8039
(870) 972-0281
(870) 972-8694
Mailing address
3120 PRESTWICK CIR, JONESBORO, AR 72401-8039
(870) 972-0281
(870) 972-8694
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5W687
BCBS
AR
Enumeration date
06/22/2006
Last updated
07/08/2007
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