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Individual
RODRIQUE DEWYANE NELSON
Active
Individual
RODRIQUE DEWYANE NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
143857
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP121393
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
295305101
—
TX
05
—
295305102
—
TX
01
—
8485UC
BLUE CROSS BLUE SHIELD
TX
01
—
P01097803
RAILROAD MEDICARE
TX
Enumeration date
01/13/2012
Last updated
06/05/2018
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