Individual
KENDRA VERSHON BASKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6606 LBJ FWY, SUITE 200, DALLAS, TX 75240
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 715-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R876122
MS
367500000X
Certified Registered Nurse Anesthetist
Primary
153186
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
320708602
—
TX
01
—
8732UG
BCBS
TX
Enumeration date
03/01/2013
Last updated
05/31/2018
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