Individual
MRS. TINA ANN NALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA, MSNA
Contact information
Practice address
638 CALIFORNIA AVE SW, CAMDEN, AR 71701-4604
(870) 836-1000
Mailing address
249 DALLAS 262, SPARKMAN, AR 71763-8690
(870) 687-3821
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C01505
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156044001
—
AR
01
—
202199067
FEDERAL ID NUMBER
AR
Enumeration date
01/02/2007
Last updated
04/22/2011
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