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NPI Code Detail

MEDICARE: MRS. SUSAN ANN MACLARY CRNA

MEDICARE: MRS. SUSAN ANN MACLARY 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
1367500000XCertified Registered Nurse AnesthetistRN221172LPA
2367500000XCertified Registered Nurse Anesthetist0024166870VA

General Provider Information

NPI Number : 1841293362
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN ANN MACLARY CRNA
Provider Business Mailing Address
First Line : 5224 LOWERY DOWNS
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23464-5616
Country : US
Telephone Number : 757-216-9913
Fax Number :
Provider Business Practice Location Address
First Line : 736 BATTLEFIELD BLVD N
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23320-4941
Country : US
Telephone Number : 757-312-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2005
Last Update Date : 08/26/2008

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Directions to “ MRS. SUSAN ANN MACLARY CRNA” Practice Location

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