Organization
CLOUD NINE ANESTHESIA PA
Active
Organization
CLOUD NINE ANESTHESIA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY LYNN DAVENPORT CRNA (OWNER)
(501) 442-1640
Entity
Organization
Contact information
Practice address
9101 KANIS RD STE 300, LITTLE ROCK, AR 72205-6453
(501) 771-4370
(501) 327-9722
Mailing address
191 PLANTATION DR, MAYFLOWER, AR 72106-8420
(501) 771-4370
(501) 327-9722
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
C02646
AR
Other
Enumeration date
05/27/2009
Last updated
05/27/2009
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