Healthcare Provider Details

I. General information

NPI: 1336181353
Provider Name (Legal Business Name): BRIAN PITCHER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 09/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 GEORGIA AVE NW
WASHINGTON DC
20307-0003
US

IV. Provider business mailing address

4701 NEWCOMB PL
ALEXANDRIA VA
22304
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-6481
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP30006160
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: