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General NPI Number Information
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NPI Number | 1629134143
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Entity Type | Individual
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Provider Name | MARY KAY PIEMONTE CRNA
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Gender | Female
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6355 WALKER LN 200
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City | ALEXANDRIA
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State | VA
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Zip | 22310-3245
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Country | US
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Telephone | 703-922-9501
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Fax | 703-922-5347
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Provider Business Mailing Address
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Address Line | 208 E RIDGEVILLE BLVD # 201
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City | MOUNT AIRY
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State | MD
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Zip | 21771-5219
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Country | US
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Telephone | 301-829-7683
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Fax | 301-829-7694
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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 | 0024085115
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License Number State | VA
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