Teisha St Rose, | |
1050 W Perimeter Rd, Andrews Air Force Base, MD 20762-6601 | |
(240) 857-5911 | |
Not Available |
Full Name | Teisha St Rose |
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Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 1050 W Perimeter Rd, Andrews Air Force Base, Maryland |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316378896 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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367500000X | Nurse Anesthetist, Certified Registered | RN.328985 (Ohio) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 0024171634 (Virginia) | Primary |
Entity Name | American Anesthesiology Of Virginia Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417994872 PECOS PAC ID: 6800790023 Enrollment ID: O20031120000429 |
Entity Name | Corridor Anesthesia, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720053887 PECOS PAC ID: 0941231153 Enrollment ID: O20050827000142 |
Entity Name | Columbia Outpatient Sedation Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1588921225 PECOS PAC ID: 3476718792 Enrollment ID: O20170128000015 |
Mailing Address | Practice Location Address |
---|---|
Teisha St Rose, 13842 Rembrandt Way, Chantilly, VA 20151-3255 Ph: () - | Teisha St Rose, 1050 W Perimeter Rd, Andrews Air Force Base, MD 20762-6601 Ph: (240) 857-5911 |
Mr. Matthew Robert Uber, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1050 W Perimeter Rd, Andrews Air Force Base, MD 20762 Phone: 937-684-1009 |