Individual
AARON W BLACKERBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1910 MALVERN AVE, HOT SPRINGS, AR 71901-7752
(501) 321-1000
(501) 620-2336
Mailing address
PO BOX 22390, HOT SPRINGS, AR 71903-2390
(800) 235-1415
(913) 234-1108
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R65096
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
C02704
AR
367500000X
Certified Registered Nurse Anesthetist
CTP000076
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170501001
—
AR
01
—
P00670667
RR MEDICARE GROUP CK6327
AR
Enumeration date
06/02/2008
Last updated
03/17/2009
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