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General NPI Number Information
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NPI Number | 1366112906
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Entity Type | Organization
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Legal Business Name | TRAVELING CRNA LLC
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Dates
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Enumeration Date | 09/15/2021
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Last Update Date | 09/15/2021
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Provider Practice Location Address
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Address Line | 5233 KING AVE STE 208
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City | ROSEDALE
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State | MD
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Zip | 21237-4003
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Country | US
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Telephone | 443-889-8558
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Fax |
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Provider Business Mailing Address
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Address Line | 6210 BRIAR CT
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City | ELKRIDGE
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State | MD
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Zip | 21075-5941
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Country | US
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Telephone | 443-889-8558
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Fax |
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Authorized Official
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Title or Position | CRNA/OWNER
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Name | ANNE MUNTUERTO
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Credential |
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Telephone | 443-889-8558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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