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General NPI Number Information
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NPI Number | 1073587333
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Entity Type | Individual
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Provider Name | ADA SPISAK CRNA
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Gender | Female
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 04/09/2015
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Provider Practice Location Address
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Address Line | 325 S BELMONT ST
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City | YORK
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State | PA
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Zip | 17403-2608
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Country | US
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Telephone | 717-843-8623
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Fax |
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Provider Business Mailing Address
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Address Line | 3998 FAIR RIDGE DR
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City | FAIRFAX
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State | VA
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Zip | 22033-2921
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Country | US
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Telephone | 703-295-9360
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Fax | 703-766-9725
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1349A
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License Number State | KY
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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 | RN250322L
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License Number State | PA
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