Provider Demographics
NPI:1982857280
Name:LAUKHUF, MARILYNN LOUISE (CRNA)
Entity Type:Individual
Prefix:
First Name:MARILYNN
Middle Name:LOUISE
Last Name:LAUKHUF
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 1:3304 LOVERS LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-7628
Mailing Address - Country:US
Mailing Address - Phone:214-692-7450
Mailing Address - Fax:
Practice Address - Street 1:9101 N CENTRAL EXPY
Practice Address - Street 2:SUITE 650
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-5927
Practice Address - Country:US
Practice Address - Phone:214-821-8613
Practice Address - Fax:214-821-4958
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX437154367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered