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General NPI Number Information
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NPI Number | 1699072512
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Entity Type | Individual
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Provider Name | BETHANY M ZAWISZA CRNA
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Gender | Female
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Dates
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Enumeration Date | 02/14/2011
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Last Update Date | 02/14/2011
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Provider Practice Location Address
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Address Line | 115 BALTIMORE ST STE 200 BOX 1571
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City | CUMBERLAND
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State | MD
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Zip | 21502-2301
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Country | US
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Telephone | 301-723-4965
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Fax | 301-723-4983
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Provider Business Mailing Address
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Address Line | 288 W MUD PIKE
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City | ROCKWOOD
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State | PA
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Zip | 15557-6944
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Country | US
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Telephone | 724-433-4867
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Fax | 301-723-4983
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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 | R193597
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License Number State | MD
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