Organization
MODERN ANESTHESIA CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL D GIBSON (AR/CREDENTIALING MANAGER)
(615) 620-2336
Entity
Organization
Contact information
Practice address
810 MERRIMAN ST, CONWAY, AR 72032-4436
(501) 329-3937
Mailing address
PO BOX 290342, NASHVILLE, TN 37229-0342
(615) 620-2320
(615) 620-2323
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
12/04/2020
Last updated
12/04/2020
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