Provider Demographics
NPI:1922326131
Name:HARRIS, BILLY HEATH (CRNA)
Entity Type:Individual
Prefix:MR
First Name:BILLY
Middle Name:HEATH
Last Name:HARRIS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
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Mailing Address - Street 1:3810 CENTRAL AVENUE, SUITE H
Mailing Address - Street 2:MIDSTATE MEDICAL SERVICES
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6921
Mailing Address - Country:US
Mailing Address - Phone:501-525-5840
Mailing Address - Fax:501-525-1762
Practice Address - Street 1:300 WERNER
Practice Address - Street 2:ST. JOSEPH'S HOSPITAL
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6921
Practice Address - Country:US
Practice Address - Phone:501-622-1975
Practice Address - Fax:501-622-1925
Is Sole Proprietor?:No
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX#R701958163W00000X
AR#CTP-00130367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse