Individual
MARK DANIEL NOORLANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
77 W FOREST AVE, SUITE 207, FLAGSTAFF, AZ 86001-1479
(928) 773-2505
(928) 773-2504
Mailing address
77 W FOREST AVE, SUITE 207, FLAGSTAFF, AZ 86001-1479
(928) 773-2505
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
90703
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
764113
—
AZ
Enumeration date
09/12/2012
Last updated
06/16/2017
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