Provider Demographics
NPI:1023065398
Name:FURR, WILLIE FRANK (CRNA)
Entity type:Individual
Prefix:MR
First Name:WILLIE
Middle Name:FRANK
Last Name:FURR
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 1:849 S THREE NOTCH ST
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-5325
Mailing Address - Country:US
Mailing Address - Phone:334-222-8466
Mailing Address - Fax:334-222-9811
Practice Address - Street 1:849 S THREE NOTCH ST
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-5325
Practice Address - Country:US
Practice Address - Phone:334-222-8466
Practice Address - Fax:334-222-9811
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-089834367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL09980435Medicaid
AL51524922OtherBCBS PROVIDER NUMBER
AL51524922OtherBCBS PROVIDER NUMBER