MEDICARE: PATRICIA KINDRED CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	1095580	KY
2	367500000X	Certified Registered Nurse Anesthetist	0024170269	VA

General Provider Information

NPI Number	:	1194056218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA KINDRED CRNA

Provider Business Mailing Address
First Line	:	2817 REILLY ST
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-7324
Country	:	US
Telephone Number	:	910-907-7668
Fax Number	:

Provider Business Practice Location Address
First Line	:	1420 SPRING HILL RD STE 210
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-3039
Country	:	US
Telephone Number	:	703-738-4342
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2010
Last Update Date	:	02/10/2023

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Directions to “ PATRICIA KINDRED CRNA” Practice Location

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