Healthcare Provider Details

I. General information

NPI: 1093807646
Provider Name (Legal Business Name): EUGENE ALBERT VAJNA CRNA, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8008 W POINT DR
SPRINGFIELD VA
22153-3018
US

IV. Provider business mailing address

9300 DEWITT LOOP
FORT BELVOIR VA
22060-5285
US

V. Phone/Fax

Practice location:
  • Phone: 703-455-5763
  • Fax:
Mailing address:
  • Phone: 571-231-3224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP1627772
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number28171527A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: