Provider Demographics
NPI:1437147469
Name:ZORYCHTA, MARY ANN (CRNA)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:ANN
Last Name:ZORYCHTA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:ANN
Other - Last Name:MYERS PRITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 22390
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-2390
Mailing Address - Country:US
Mailing Address - Phone:800-235-1415
Mailing Address - Fax:913-234-1108
Practice Address - Street 1:2001 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-8124
Practice Address - Country:US
Practice Address - Phone:870-777-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC01548367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR159089001Medicaid
AR5Y587OtherBCBS
P00278593OtherRR MEDICARE GROUP CK6327
WV23477OtherSTATE RN LICENSE
AR5Y587Medicare PIN
AR5Y587OtherBCBS