Provider Demographics
NPI:1073538435
Name:RICHARDS, MAUREEN ANNE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:ANNE
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5027 LILAC LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75209-3329
Mailing Address - Country:US
Mailing Address - Phone:214-366-9392
Mailing Address - Fax:
Practice Address - Street 1:9301 N CENTRAL EXPY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0806
Practice Address - Country:US
Practice Address - Phone:214-265-2810
Practice Address - Fax:214-265-2820
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX519258367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX89783UOtherBCBSTX
TX89942UOtherBCBS
TX89942UOtherBCBS
TX8F21022Medicare PIN
TXP00696211Medicare PIN
TX86035UMedicare UPIN
TX8F2431Medicare ID - Type Unspecified