Provider Demographics
NPI:1487937223
Name:FARNELL, ALVA DENISE (CRNA)
Entity type:Individual
Prefix:
First Name:ALVA
Middle Name:DENISE
Last Name:FARNELL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4926 S TONTI ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70125-4744
Mailing Address - Country:US
Mailing Address - Phone:504-756-4565
Mailing Address - Fax:504-821-4202
Practice Address - Street 1:4926 S TONTI ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70125-4744
Practice Address - Country:US
Practice Address - Phone:504-756-4565
Practice Address - Fax:504-821-4202
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN081484-AP06622367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered