Healthcare Provider Details

I. General information

NPI: 1679627723
Provider Name (Legal Business Name): MEREDITH L. WALDO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEREDITH L. EGLOFF

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N HIGHLAND AVE
SHERMAN TX
75092-7354
US

IV. Provider business mailing address

119 W HOUSTON ST
SHERMAN TX
75090-5909
US

V. Phone/Fax

Practice location:
  • Phone: 903-891-7000
  • Fax: 903-893-5334
Mailing address:
  • Phone: 903-891-7000
  • Fax: 903-893-5334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number684257
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: