Individual
MR. CRAIG ALLAN ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 648-6400
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(469) 291-3369
(214) 648-5461
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
66768
CO
367500000X
Certified Registered Nurse Anesthetist
Primary
AP134976
TX
367500000X
Certified Registered Nurse Anesthetist
CRA-2470
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117080500
—
WY
01
—
430070795
MEDICARE RAILROAD
CO
05
—
90551885
—
CO
Enumeration date
10/10/2005
Last updated
08/17/2020
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