Provider Demographics
NPI:1942288964
Name:BORDERS, JEFFERY RICHARD (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:RICHARD
Last Name:BORDERS
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:USAMEDDAC WUERZBURG
Mailing Address - Street 2:ATTN: CREDENTIALS UNIT 26610
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09244
Mailing Address - Country:DE
Mailing Address - Phone:01149931-804-3616
Mailing Address - Fax:01149931-804-3241
Practice Address - Street 1:USAMEDDAC WUERZBURG
Practice Address - Street 2:ATTN: CREDENTIALS UNIT 26610
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09244
Practice Address - Country:DE
Practice Address - Phone:01149931-804-3616
Practice Address - Fax:01149931-804-3241
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDRNA-580367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered