Provider Demographics
NPI:1629154174
Name:SMITH, SARAH ELIZABETH (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:KRUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1515 BOYDS BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76005-1314
Mailing Address - Country:US
Mailing Address - Phone:214-952-5773
Mailing Address - Fax:
Practice Address - Street 1:1001 N WALDROP DR STE 701
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4704
Practice Address - Country:US
Practice Address - Phone:214-952-5773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX599829367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86318UOtherBCBS OF TEXAS
TXP00301992OtherRAILROAD MEDICARE PART B
TXP00301992OtherRAILROAD MEDICARE PART B
TX8G3777Medicare ID - Type UnspecifiedPART B TEXAS
TX8K8182Medicare PIN