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Individual

AMANDA LYNN RAE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1001 SAM PERRY BLVD, FREDERICKSBURG, VA 22401-4453
(540) 741-7614
Mailing address
1340 CENTRAL PARK BLVD STE 100, FREDERICKSBURG, VA 22401-4940
(540) 741-4254

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024184271
VA
367500000X
Certified Registered Nurse Anesthetist
95001449
CA

Other

Enumeration date
12/04/2020
Last updated
05/01/2026
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