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Individual

KYLE CLIFFTON DENNIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2910 JENNY LIND RD, FORT SMITH, AR 72901-6735
(479) 785-2555
(479) 785-3555
Mailing address
PO BOX 11286, FORT SMITH, AR 72917-1286
(479) 785-2555
(479) 785-3555

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C01542
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
159007001
AR
05
200073830A
OK
Enumeration date
08/31/2006
Last updated
06/04/2009
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