Healthcare Provider Details

I. General information

NPI: 1083202048
Provider Name (Legal Business Name): PETRA SPENCER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PETRA GERBER RN

II. Dates (important events)

Enumeration Date: 01/05/2021
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

8901 ROCKVILLE PIKE
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 210-542-2011
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAC003797
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9519497
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: