Individual
RONALD DANIEL VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 SAINT MARY PLACE, PFS-PROF BILLING, SHREVEPORT, LA 71101
(318) 681-6878
(318) 681-6753
Mailing address
1 SAINT MARY PLACE, PFS-PROF BILLING, SHREVEPORT, LA 71101
(318) 681-6878
(318) 681-6753
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN089453
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467201
—
LA
Enumeration date
10/02/2006
Last updated
07/09/2007
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