Wierda, Bradley

Wierda, Bradley is an individual health care provider with primary practice located at 2710 Rife Medical Lane Anesthesia Dept, Rogers AR 72758-1452. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Wierda, Bradley can be contacted via phone (479) 338-8000.

Contact Information

Primary practice address
2710 Rife Medical Lane Anesthesia Dept Rogers AR 72758-1452
Phone: (479) 338-8000
Fax: (479) 338-3056
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X C02770 Arkansas

Profile Details

NPI number 1770560518
LBN Legal business name Wierda, Bradley
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2005
Last updated Jun 18th, 2021 - about 4 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 1770560518 NPPES
Missouri MEDICAID 1770560518
Missouri MEDICAID 179913001
Missouri MEDICAID 200347410A
Missouri Other 5V232
Missouri Other P00755473

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