Individual
DIANE D AVERY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2415 E YANDELL DR, STE B, EL PASO, TX 79903-3616
(915) 577-0030
(915) 533-2568
Mailing address
PO BOX 3899, EL PASO, TX 79923-3899
(915) 577-0030
(915) 533-2568
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
426206
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22625
NURSE ANESTHETISTS
—
Enumeration date
08/24/2005
Last updated
07/08/2007
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