Individual
LANORVELL ROBERTSON
Active
Individual
LANORVELL ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R036279
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KCB1CH
CAREFIRST BCBS
MD
01
—
P00745079
MEDCIARE RAILROAD (GRP PTAN DD6120)
MD
01
—
P00811167
MEDICARE RAILROAD (GRP PTAN CJ8689)
MD
01
—
S417-0037
CAREFIRST BCBS
DC
Enumeration date
09/20/2005
Last updated
05/07/2010
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