Provider Demographics
NPI:1487187647
Name:ARCHER, LADONNA LAQUESHA PRICE (CRNA)
Entity Type:Individual
Prefix:
First Name:LADONNA
Middle Name:LAQUESHA PRICE
Last Name:ARCHER
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 1:2521 VICARA CT
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1479
Mailing Address - Country:US
Mailing Address - Phone:561-254-1898
Mailing Address - Fax:
Practice Address - Street 1:2521 VICARA CT
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1479
Practice Address - Country:US
Practice Address - Phone:561-254-1898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9327556367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered