Individual
MRS. TRACIE LOSCALZO
Active
Sole proprietor
No
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
3100 SPRING FOREST RD STE 130, RALEIGH, NC 27616-2880
(800) 280-9533
(919) 873-9821
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024169473
VA
367500000X
Certified Registered Nurse Anesthetist
RN69034
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497983845
—
UT
05
—
36238813
—
NM
05
—
454719
—
AZ
05
—
92473075
—
CO
01
—
P00753285
RR MEDICARE
NM
Enumeration date
06/24/2009
Last updated
03/17/2018
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