Individual
VIRGINIA S MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
500 S UNIVERSITY AVE, SUITE 505, LITTLE ROCK, AR 72205-5307
(501) 664-4532
(501) 663-4335
Mailing address
500 S UNIVERSITY AVE, SUITE 505, LITTLE ROCK, AR 72205-5307
(501) 664-4532
(501) 663-4335
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C00128
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59552
BLUE CROSS BLUE SHIELD
AR
Enumeration date
09/29/2005
Last updated
12/04/2007
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