Individual
DIANE L SKELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1500 CITYWEST BLVD, STE. 300, HOUSTON, TX 77042-2300
(713) 620-4000
(713) 458-4229
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
AP113999
TX
367500000X
Certified Registered Nurse Anesthetist
RN075703
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191676902
—
TX
01
—
86086U
BCBS
TX
01
—
P00304885
RR MEDICARE
TX
Enumeration date
09/27/2005
Last updated
04/23/2020
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