Provider Demographics
NPI:1770643330
Name:FLOYD, DASHIELLE REDDELL (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:DASHIELLE
Middle Name:REDDELL
Last Name:FLOYD
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 1:1212 C R 13500W
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75462
Mailing Address - Country:US
Mailing Address - Phone:903-737-8991
Mailing Address - Fax:
Practice Address - Street 1:820 CLARKSVILLE ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-6027
Practice Address - Country:US
Practice Address - Phone:903-737-3122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44450 CRNA282N00000X
TXAP105386367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No282N00000XHospitalsGeneral Acute Care Hospital