Individual
CARLY KRUMNOW PESCHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
901 W BEN WHITE BLVD, AUSTIN, TX 78704-6903
(512) 447-2211
Mailing address
510 GALLAGHER DRIVE, CANYON LAKE, TN 77133
(361) 537-7026
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
859877
TX
207L00000X
Anesthesiology Physician
131527
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
131527
TX
Other
Enumeration date
12/08/2020
Last updated
04/10/2024
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