Individual
RAMONA ANQUENETTE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1601 NEW CASTLE RD, FORREST CITY, AR 72335-2218
(870) 261-0513
(901) 261-2542
Mailing address
PO BOX 771522, MEMPHIS, TN 38177-1522
(901) 747-4624
(901) 261-2542
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R063478
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
C002753
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13637618
CAQH DATABASE
AR
05
—
177920001
—
AR
01
—
1861636011
AETNA HEALTHCARE
AR
01
—
5V169
BLUE CROSS BLUE SHIELD
AR
Enumeration date
04/30/2009
Last updated
11/17/2015
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