Provider Demographics
NPI:1578951539
Name:PRINE, SARA RACHEL (CRNA)
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:RACHEL
Last Name:PRINE
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:1 CHILDRENS WAY # 653
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-1100
Mailing Address - Fax:501-364-4082
Practice Address - Street 1:2601 GENE GEORGE BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762
Practice Address - Country:US
Practice Address - Phone:479-725-6880
Practice Address - Fax:479-725-6582
Is Sole Proprietor?:No
Enumeration Date:2014-12-29
Last Update Date:2018-10-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARC003062367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered