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General NPI Number Information
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NPI Number | 1649299348
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Entity Type | Individual
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Provider Name | THOMAS CRAVENS CRNA
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 2560 SAMARITAN DR
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City | LAS CRUCES
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State | NM
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Zip | 88001-1170
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Country | US
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Telephone | 800-421-8274
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Fax |
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Provider Business Mailing Address
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Address Line | 7550 PYRAMID PEAK LN
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City | LAS CRUCES
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State | NM
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Zip | 88011-8386
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Country | US
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Telephone | 314-910-1738
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 113575
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | CRNA00749
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License Number State | NM
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