Individual
RAYMOND R (RUSTY) SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
241 AIMEE RD, FERRIDAY, LA 71334-9615
(318) 757-6371
(318) 757-6371
Mailing address
241 AIMEE RD, FERRIDAY, LA 71334-9615
(318) 757-6371
(318) 757-7847
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
R611034
MS
367500000X
Certified Registered Nurse Anesthetist
Primary
RN032208
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00127016
—
MS
01
—
050584209A
MS BLUE CROSS
MS
05
—
1139351
—
LA
Enumeration date
02/13/2006
Last updated
02/10/2009
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