Forty Winks Anesthesia, PA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C02646 Issued in AR

Legal business name

FORTY WINKS ANESTHESIA, PA

Practice address

191 Plantation Dr
Mayflower, AR 72106-8420

Phone

(501) 771-4693

Fax

(501) 771-4885

NPI assigned

Mar 18, 2008

Last updated

Apr 23, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracy L Davenport, CRNA

Title

Owner

Phone

(501) 771-4693

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1427229491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 PLANTATION DR",
            "city": "MAYFLOWER",
            "state": "AR",
            "postal_code": "721068420",
            "telephone_number": "501-771-4693",
            "fax_number": "501-771-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 PLANTATION DR",
            "city": "MAYFLOWER",
            "state": "AR",
            "postal_code": "721068420",
            "telephone_number": "501-771-4693",
            "fax_number": "501-771-4885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTY WINKS ANESTHESIA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "DAVENPORT",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-771-4693",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C02646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Elliott, LCSW
• Anna Farley
• Jami Lynn Faulkner, MS, RD, LD
• Harley Ferguson
• Hailey J. Fogleman, M.S., CCC-SLP
• Angela D Foster, APN
• Carrington Franklin
• Alissa Gordon, SLPA
• Blair Greenwood, M.D.
• H&H Therapy LLC

• Certified Registered Nurse Anesthetist in Mayflower, AR
• Providers in Mayflower, AR by specialty
• Certified Registered Nurse Anesthetist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.