Healthcare Provider Details

I. General information

NPI: 1013990175
Provider Name (Legal Business Name): LYNDA A ANGELONE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNDA CATHERINE WHITEHEAD CRNA

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 01/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5656 WEST BEE CAVES ROAD SUITE M-302
AUSTIN TX
78746-5236
US

IV. Provider business mailing address

1004 SOUTH ROCK STREET WESTLAKE ANESTHESIA GROUP, PA
GEORGETOWN TX
78626
US

V. Phone/Fax

Practice location:
  • Phone: 512-697-3502
  • Fax: 512-697-3501
Mailing address:
  • Phone: 512-279-0348
  • Fax: 512-371-8788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number70297
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: