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NPI Code Detail

MEDICARE: DR. KELLY RENEE KATCHER M.D

MEDICARE: DR. KELLY RENEE KATCHER M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician036110671IL
2207L00000XAnesthesiology Physician79605CT
3207L00000XAnesthesiology PhysicianP5540TX
4207L00000XAnesthesiology Physician18574NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P01292155OTHERTXRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
38DT434OTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1548203391
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KELLY RENEE KATCHER M.D
Provider Business Mailing Address
First Line : 2419 GRANADA BLUFF CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89135-1340
Country : US
Telephone Number : 773-936-6440
Fax Number :
Provider Business Practice Location Address
First Line : 7160 RAFAEL RIVERA WAY STE 210
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-5395
Country : US
Telephone Number : 888-339-8727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2006
Last Update Date : 05/01/2025

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Directions to “ DR. KELLY RENEE KATCHER M.D” Practice Location

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