Individual
NICHOLAS ALLEN DUFRENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
600 S TYLER ST STE 2100, AMARILLO, TX 79101-2304
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP120749
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281454301
—
TX
05
—
281454302
—
TX
01
—
8631UB
BLUE CROSS BLUE SHIELD
TX
01
—
P00962840
RR MEDICARE
TX
Enumeration date
05/20/2011
Last updated
04/23/2020
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