MEDICARE: MRS. TINA FUJIKO BARBERAN CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	0024171545	VA
2	367500000X	Certified Registered Nurse Anesthetist	AC002326	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013332303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TINA FUJIKO BARBERAN CRNA

Provider Business Mailing Address
First Line	:	1302 RISING RIDGE RD
Second Line	:	SUITE 1
City	:	MOUNT AIRY
State	:	MD
Zip	:	21771-5790
Country	:	US
Telephone Number	:	301-829-7683
Fax Number	:

Provider Business Practice Location Address
First Line	:	1302 RISING RIDGE RD
Second Line	:	SUITE 1
City	:	MOUNT AIRY
State	:	MD
Zip	:	21771-5790
Country	:	US
Telephone Number	:	301-829-7683
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2014
Last Update Date	:	10/04/2023

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