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Individual
WHITNEY L KELLEY-MAHANA
Active
Individual
WHITNEY L KELLEY-MAHANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
728043
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200470090A
—
OK
05
—
313042902
—
TX
01
—
8766UG
BCBS TX
TX
01
—
8768UD
BCBS
TX
01
—
P01446371
RR
TX
Enumeration date
11/09/2012
Last updated
07/12/2016
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