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General NPI Number Information
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NPI Number | 1003031121
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Entity Type | Organization
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Legal Business Name | COMFORT CARE ANESTHESIA LLC
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 04/01/2008
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Provider Practice Location Address
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Address Line | 10512 TWIN CEDAR CT
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City | LAUREL
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State | MD
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Zip | 20723-5721
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Country | US
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Telephone | 301-497-9944
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Fax |
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Provider Business Mailing Address
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Address Line | 10512 TWIN CEDAR CT
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City | LAUREL
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State | MD
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Zip | 20723-5721
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Country | US
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Telephone | 301-497-9944
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Fax |
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Authorized Official
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Title or Position | CRNA
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Name | MRS. TAWYANA MAE FLEMING
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Credential | CRNA
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Telephone | 301-497-9944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 35280
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 180984
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 1499
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R143442
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License Number State | MD
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