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General NPI Number Information
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NPI Number | 1588686612
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Entity Type | Individual
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Provider Name | SHAZEEDA AVERITT CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 07/30/2014
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Provider Practice Location Address
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Address Line | 621 RIDGELY AVENUE
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City | ANNAPOLIS
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State | MD
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Zip | 21401
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Country | US
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Telephone | 410-266-1588
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Fax |
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Provider Business Mailing Address
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Address Line | 621 RIDGELY AVENUE SUITE 204
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City | ANNAPOLIS
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State | MD
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Zip | 21401
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Country | US
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Telephone | 410-266-1588
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Fax | 410-266-6931
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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 | R198233
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License Number State | MD
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