Individual
LEE ANN SPEED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 918-7000
Mailing address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001151641
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024165672
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010004845
—
VA
01
—
Q41733A
MEDICARE PTAN
VA
Enumeration date
06/10/2005
Last updated
08/31/2016
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