Individual
ASHLEY MAZUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1300 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2111
(972) 715-5007
(972) 715-5682
Mailing address
PO BOX 650426, DALLAS, TX 75265-0426
(972) 715-5007
(972) 715-5682
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
696207
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
081145
CRNA CERTIFICATE
TX
01
—
696207
STATE LICENSE
TX
Enumeration date
12/23/2008
Last updated
12/23/2008
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