Individual
BETTY S TINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
624 HOSPITAL DRIVE, MOUNTAIN HOME, AR 72653-2955
(870) 508-1000
Mailing address
PO BOX 2336, MOUNTAIN HOME, AR 72654-2336
(870) 424-7070
(870) 424-6616
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C00881
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124469701
—
AR
05
—
129712001
—
AR
01
—
55651
BCBS
AR
01
—
P00173650
RAILROAD MEDICARE
—
Enumeration date
08/15/2006
Last updated
09/22/2011
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