Provider Demographics
NPI:1336117142
Name:TRUAX-WAITS, SHELLEY D (CRNA)
Entity Type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:D
Last Name:TRUAX-WAITS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:SHELLEY
Other - Middle Name:D
Other - Last Name:TRUAX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1317 CREEK VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-1374
Mailing Address - Country:US
Mailing Address - Phone:901-854-5942
Mailing Address - Fax:
Practice Address - Street 1:6606 LBJ FWY STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6524
Practice Address - Country:US
Practice Address - Phone:214-715-5000
Practice Address - Fax:715-715-9976
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000011003367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered