Provider Demographics
NPI:1154347086
Name:CARAWAY, WILLIAM KENT (CRNA)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:KENT
Last Name:CARAWAY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WALTERS ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-4699
Mailing Address - Country:US
Mailing Address - Phone:337-475-8333
Mailing Address - Fax:
Practice Address - Street 1:1000 WALTERS ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-4699
Practice Address - Country:US
Practice Address - Phone:337-475-8333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN626905367500000X
LAAP02415367500000X
LA017992367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1920799Medicaid
26905OtherBLUE CROSS
F33789Medicare UPIN
LA1920799Medicaid