Healthcare Provider Details

I. General information

NPI: 1235105511
Provider Name (Legal Business Name): EDDE KAREN SPRINGER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 05/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MEDICAL PARK BLVD
PETERSBURG VA
23805-9274
US

IV. Provider business mailing address

PO BOX 17978
RICHMOND VA
23226-7978
US

V. Phone/Fax

Practice location:
  • Phone: 804-765-5060
  • Fax:
Mailing address:
  • Phone: 804-288-4453
  • Fax: 804-288-1621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN189005L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024164340
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: