Halliburton, Theresa B

Halliburton, Theresa B is an individual health care provider with primary practice located at 11115 So Waldron Rd 107, Fort Smith AR 72903-2584. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Halliburton, Theresa B can be contacted via phone (479) 452-1581.

Contact Information

Primary practice address
11115 So Waldron Rd 107 Fort Smith AR 72903-2584
Phone: (479) 452-1581
Fax: (479) 452-2148
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X C01018 CRNA Arkansas

Profile Details

NPI number 1922176437
LBN Legal business name Halliburton, Theresa B
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2006
Last updated Jun 24th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922176437 NPPES
Arkansas MEDICAID 136416701

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