Healthcare Provider Details

I. General information

NPI: 1790283505
Provider Name (Legal Business Name): ANN MOORHEAD ANESTHESIA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2018
Last Update Date: 02/19/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 S SALISBURY BLVD
SALISBURY MD
21801-7127
US

IV. Provider business mailing address

PO BOX 1375
EASTON MD
21601-8926
US

V. Phone/Fax

Practice location:
  • Phone: 410-749-1191
  • Fax: 410-749-3319
Mailing address:
  • Phone: 800-222-1335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR089773
License Number StateMD

VIII. Authorized Official

Name: ANN MARIE PARRA
Title or Position: OWNER
Credential: CRNA
Phone: 410-382-9089