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Individual
TERESA MARESH
Active
Individual
TERESA MARESH
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
710725
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171550003
—
TX
01
—
87717U
BCBS
TX
01
—
P00653404
RAILROAD
TX
Enumeration date
05/12/2006
Last updated
03/12/2009
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