Provider Demographics
NPI:1376833020
Name:DUBE, NKOSIYALINDA (CRNA)
Entity Type:Individual
Prefix:
First Name:NKOSIYALINDA
Middle Name:
Last Name:DUBE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4100 INTERNATIONAL PLZ
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4820
Mailing Address - Country:US
Mailing Address - Phone:817-334-0530
Mailing Address - Fax:817-877-0350
Practice Address - Street 1:2000 E LAMAR BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-7346
Practice Address - Country:US
Practice Address - Phone:817-861-3994
Practice Address - Fax:817-877-0350
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX729580367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered