Individual
MRS. WANDA A ISDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNAP
Contact information
Practice address
9507 HOSPITAL AVENUE, NASSAWADOX, VA 23413
(757) 414-8000
Mailing address
3998 FAIR RIDGE DR, STE 300, FAIRFAX, VA 22033-2907
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0001066207
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C00228
MEDICARE ID NUMBER
VA
01
—
CA5831
RAILROAD MEDICARE PART B
VA
Enumeration date
12/11/2006
Last updated
02/12/2015
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