Organization
CROSSROADS SURGICAL ASSISTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA LYNN HAINES CNOR RNFA (FIRST ASSISTANT/OWNER)
(785) 259-4694
Entity
Organization
Contact information
Practice address
5473 CARIBOU DR, FREDERICK, CO 80504-5813
(178) 525-9469
Mailing address
PO BOX 241, FREDERICK, CO 80530-0241
(785) 259-4694
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
05/11/2021
Last updated
05/11/2021
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