Individual
MYRNA BORDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1644
(270) 825-5100
Mailing address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4705A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000374836
BCBS PROVIDER NUMBER
—
01
—
4705A
LICENSE
KY
05
—
74010794
—
KY
Enumeration date
09/17/2006
Last updated
01/07/2015
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