Individual
LAURA ELIZABETH STANDRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
13737 NOEL ROAD, SUITE 1400, DALLAS, TX 75240-2004
(972) 715-5000
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 715-5000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
751903
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312796101
—
TX
01
—
8770UD
BCBS PIN
TX
01
—
P01147820
RAILROAD MEDICARE
TX
Enumeration date
09/04/2012
Last updated
05/22/2014
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