Healthcare Provider Details

I. General information

NPI: 1386628675
Provider Name (Legal Business Name): KIRA PLAGGE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 N GEORGE MASON DR #2D
ARLINGTON VA
22205-3610
US

IV. Provider business mailing address

2619 BLAINE DRIVE
CHEVY CHASE MD
20815
US

V. Phone/Fax

Practice location:
  • Phone: 703-558-2438
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR164862
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: