Individual
JEANIE KIM LADD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4320 SEMINARY RD, ALEXANDRIA, VA 22304-1535
(703) 504-3789
(703) 295-9369
Mailing address
PO BOX 37090, BALTIMORE, MD 21297-3090
(703) 295-9360
(703) 295-9369
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024169448
VA
Other
Enumeration date
01/31/2011
Last updated
09/21/2011
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