MEDICARE: ADDIE KAY CANT 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	0024174901	VA

General Provider Information

NPI Number	:	1124557384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADDIE KAY CANT CRNA

Provider Business Mailing Address
First Line	:	10800 MIDLOTHIAN TPKE STE 265
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-4700
Country	:	US
Telephone Number	:	804-594-2622
Fax Number	:	804-594-0915

Provider Business Practice Location Address
First Line	:	10800 MIDLOTHIAN TPKE STE 265
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-4700
Country	:	US
Telephone Number	:	804-594-2622
Fax Number	:	804-594-0915

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

Provider Enumeration Date	:	06/09/2017
Last Update Date	:	07/21/2022

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Directions to “ ADDIE KAY CANT CRNA” Practice Location

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