NPI 1356346316

Walter P Theriot, CRNA

Practitioner Certified Registered Nurse Anesthetist Pine Bluff, AR

Practice location

Address: 1801 W 40th Ave STE 2b, Pine Bluff, AR 71603-6957
Phone: (870) 535-7457
Fax: (870) 535-2522
Mailing address: PO Box 1272, Pine Bluff, AR 71613-1272

Registered specialties

Certified Registered Nurse Anesthetist Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367500000X Licence C00615 (AR)

Other Nurse Anesthetist, Certified Registered providers in Arkansas →

Registry record

NPI: 1356346316
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Jun 2005
Record last updated: 24 Jun 2008

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.