Provider Demographics
NPI:1316266091
Name:LEFRERE, KRISTI L (CRNA)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:L
Last Name:LEFRERE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:L
Other - Last Name:GUIDRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:254-724-2111
Mailing Address - Fax:
Practice Address - Street 1:2201 CLEAR CREEK RD
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-4110
Practice Address - Country:US
Practice Address - Phone:254-526-7523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXCOMPACT367500000X
TXAP120811367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1316266091Medicaid
OK200310730AMedicaid
OK200310730AMedicaid
MO1448100004Medicare PIN