Individual
STEPHEN R SPIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
815 S 10TH ST, ELITE ANES. - CREDENTIALING, LEESVILLE, LA 71446-4611
(337) 392-5088
(337) 392-4982
Mailing address
6000 BOCAGE DR, ALEXANDRIA, LA 71303-2191
(318) 419-0756
(337) 392-4982
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN099590-AP04371
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1177440
—
LA
01
—
1861444101
BCBS OF LA
LA
01
—
P01032689
RR MEDICARE
LA
Enumeration date
05/16/2006
Last updated
09/10/2013
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