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NPI Code Detail

MEDICARE: CHERYL E SMITH CRNA

MEDICARE: CHERYL E SMITH CRNA
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
1367500000XCertified Registered Nurse Anesthetist50008TX
2367500000XCertified Registered Nurse Anesthetist581155TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11265415319OTHERNMBCBS
280722HOTHERTXBC/BS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
689985UOTHERTXBCBS

General Provider Information

NPI Number : 1265415319
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL E SMITH CRNA
Provider Business Mailing Address
First Line : PO BOX 952270
Second Line :
City : DALLAS
State : TX
Zip : 75395-0001
Country : US
Telephone Number : 972-715-5000
Fax Number :
Provider Business Practice Location Address
First Line : 3280 JOE BATTLE BLVD
Second Line :
City : EL PASO
State : TX
Zip : 79938-2622
Country : US
Telephone Number : 915-832-2171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/22/2005
Last Update Date : 09/21/2011

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