Individual
ETHAN STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1108 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 798-8111
Mailing address
2502 SCOTT RD, DOTHAN, AL 36303-1059
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-162700
AL
Other
Enumeration date
06/06/2025
Last updated
06/23/2025
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