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Individual

DAVID WILLIAM CHILDRESS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
Mailing address
501 ROBINHOOD RD, BASSETT, VA 24055-5706

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001-168448
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024-166043
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010192609
VA
05
010192676
VA
05
010192684
VA
05
010192706
VA
05
010192722
VA
Enumeration date
04/25/2006
Last updated
05/08/2008
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