Individual
MR. JASON DAVID SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4855 AIRLINE DR, APT 10B, BOSSIER CITY, LA 71111-6600
(318) 549-0378
Mailing address
4855 AIRLINE DR, APT 10B, BOSSIER CITY, LA 71111-6600
(318) 549-0378
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
095633
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174971
—
LA
Enumeration date
02/24/2006
Last updated
10/17/2008
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