Basic Information
| Provider Information | |||||||||
| NPI: | 1578026688 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUENDIA | ||||||||
| FirstName: | STEPHANIE | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 S UNIVERSITY AVE STE 500 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722055307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016644532 | ||||||||
| FaxNumber: | 5016634335 | ||||||||
| Practice Location | |||||||||
| Address1: | 1910 MALVERN AVE | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719017752 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5013211000 | ||||||||
| FaxNumber: | 5016202336 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2019 | ||||||||
| LastUpdateDate: | 05/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 120223 | AR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.