Provider Demographics
NPI:1033641998
Name:PRICE, ADRIANNA NICOLE (CRNA)
Entity Type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:NICOLE
Last Name:PRICE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ADRIANNA (AUDRY)
Other - Middle Name:NICOLE
Other - Last Name:STANART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1100 N KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-2029
Mailing Address - Country:US
Mailing Address - Phone:417-256-9111
Mailing Address - Fax:
Practice Address - Street 1:1100 N KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-2029
Practice Address - Country:US
Practice Address - Phone:417-256-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-30
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR088072163W00000X
ARC003197367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse