Provider Demographics
NPI:1457465502
Name:VARELA, DEBRA S (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:S
Last Name:VARELA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 W ILA ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701-3313
Mailing Address - Country:US
Mailing Address - Phone:479-856-8161
Mailing Address - Fax:
Practice Address - Street 1:2110 EAST MAIN
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:AR
Practice Address - Zip Code:72560
Practice Address - Country:US
Practice Address - Phone:870-269-8300
Practice Address - Fax:870-269-5630
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC001084367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR136851701Medicaid