Individual
COREY DEMAR ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
9127 W RUSSELL RD STE 110, LAS VEGAS, NV 89148
(702) 878-0070
(702) 209-2064
Mailing address
9127 W RUSSELL RD STE 110, LAS VEGAS, NV 89148-1253
(702) 878-0070
(702) 209-2064
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA000507
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891129839
—
NV
Enumeration date
08/27/2013
Last updated
08/15/2018
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