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NPI Code Detail

MEDICARE: TRENT L WALTER CRNA

MEDICARE: TRENT L WALTER 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
1367500000XCertified Registered Nurse Anesthetist0024165841VA

General Provider Information

NPI Number : 1659372357
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRENT L WALTER CRNA
Provider Business Mailing Address
First Line : PO BOX 17978
Second Line :
City : RICHMOND
State : VA
Zip : 23226-7978
Country : US
Telephone Number : 804-289-4937
Fax Number :
Provider Business Practice Location Address
First Line : 1602 SKIPWITH RD
Second Line :
City : RICHMOND
State : VA
Zip : 23229-5205
Country : US
Telephone Number : 804-289-4937
Fax Number : 804-565-6600
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 03/10/2026

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1982609913 — MARILEE WALTER CRNA
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