Organization
E.A. CONWAY MEDICAL CENTER
Active
Other names
E.A. Conway Medical Center CRNAs
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE H SOTAK MHSA (DIRECTOR OF MANAGED CARE)
(318) 675-7737
Entity
Organization
Contact information
Practice address
4864 JACKSON ST, MONROE, LA 71202-6400
(318) 330-7000
(318) 675-5666
Mailing address
4864 JACKSON ST, MONROE, LA 71202-6400
(318) 330-7000
(318) 675-5666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
129
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1799882
—
LA
Enumeration date
03/14/2007
Last updated
07/27/2010
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