Provider Demographics
NPI:1518398700
Name:SAYLOR, DARRELL WAYNE (CRNA)
Entity Type:Individual
Prefix:
First Name:DARRELL
Middle Name:WAYNE
Last Name:SAYLOR
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5955 ZEAMER AVE.
Mailing Address - Street 2:JBER HOSPITAL 673RD MEDICAL GROUP
Mailing Address - City:JBER
Mailing Address - State:AK
Mailing Address - Zip Code:99506
Mailing Address - Country:US
Mailing Address - Phone:907-580-1815
Mailing Address - Fax:
Practice Address - Street 1:5955 ZEAMER AVE.
Practice Address - Street 2:JBER HOSPITAL 673RD MEDICAL GROUP
Practice Address - City:JBER
Practice Address - State:AK
Practice Address - Zip Code:99506
Practice Address - Country:US
Practice Address - Phone:907-580-1815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA140078163W00000X
AK104777367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse