Provider Demographics
NPI:1740906650
Name:ARRIAGA, KELSEY ANN (DNP, CRNA)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:ANN
Last Name:ARRIAGA
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 DIANE CT
Mailing Address - Street 2:
Mailing Address - City:WHITE SETTLEMENT
Mailing Address - State:TX
Mailing Address - Zip Code:76108-7069
Mailing Address - Country:US
Mailing Address - Phone:580-554-3814
Mailing Address - Fax:
Practice Address - Street 1:1800 PARK PLACE AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-1302
Practice Address - Country:US
Practice Address - Phone:580-554-3814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1090064367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered