Individual
DR. KELLY RENEE KATCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
7160 RAFAEL RIVERA WAY STE 210, LAS VEGAS, NV 89113-5395
(888) 339-8727
Mailing address
2419 GRANADA BLUFF CT, LAS VEGAS, NV 89135-1340
(773) 936-6440
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036110671
IL
207L00000X
Anesthesiology Physician
Primary
18574
NV
207L00000X
Anesthesiology Physician
79605
CT
207L00000X
Anesthesiology Physician
P5540
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
321781201
—
TX
01
—
8DT434
BLUE CROSS BLUE SHIELD
TX
01
—
P01292155
RAILROAD MEDICARE
TX
Enumeration date
06/13/2006
Last updated
05/01/2025
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