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Individual

KELLY CASH EDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390
(214) 648-6400
(214) 648-5461
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
(469) 291-3369
(214) 645-0078

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
909250
TX
367500000X
Certified Registered Nurse Anesthetist
172402
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
AP129707
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
356225803
TX
01
793577
MEDICARE
TX
05
8052730
NC
01
P00662407
RAILROAD-MEDICARE
NC
Enumeration date
10/04/2006
Last updated
03/11/2021
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