Organization
FORTY WINKS ANESTHESIA, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY L DAVENPORT CRNA (OWNER)
(501) 771-4693
Entity
Organization
Contact information
Practice address
191 PLANTATION DR, MAYFLOWER, AR 72106-8420
(501) 771-4693
(501) 771-4885
Mailing address
191 PLANTATION DR, MAYFLOWER, AR 72106-8420
(501) 771-4693
(501) 771-4885
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C02646
AR
Other
Enumeration date
03/18/2008
Last updated
04/23/2008
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