Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1124084504

Unknown Individual is a healthcare provider. based in Wylie, Texas. specializing in Certified Registered Nurse Anesthetist. They hold a License No. 214991 (TX). The NPI Number for Unknown Individual is 1124084504

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124084504
Phone
(214) 674-9604
Address
PO BOX 2497
Deactivation Date
17 January 2022
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Wylie Post Office, Dinwiddie Street, Crawford-Roberts, Pittsburgh, Allegheny County, Pennsylvania, 15219, United States

    WYLIE, TX 750982497

    Phone: (214) 674-9604

    Type: Mailing

  • 108, Bayou Drive, Niceville, Okaloosa County, Florida, 32578, United States

    NATIONWIDE ANESTHESIA SERVICES, INC. (LOCUM TENES)

    NICEVILLE, FL 325782303

    Phone: (800) 338-1699

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75098)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1124084504.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Certified Registered Nurse Anesthetist is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Wylie, Texas; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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