NPI 1104363258

Brent Willis, CRNA

Practitioner Certified Registered Nurse Anesthetist Texarkana, TX

Practice location

Address: 203 La Grange Dr., Texarkana, TX 75501
Phone: (936) 645-5428

Registered specialties

Certified Registered Nurse Anesthetist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence AP133014 (TX)

Other Nurse Anesthetist, Certified Registered providers in Texas →

Registry record

NPI: 1104363258
Entity type: Individual
Sex (as registered): Male
NPI issued: 27 Jan 2017
Record last updated: 27 Jan 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.