Organization
EASTERN VIRGINIA ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBY-JO A LUTNER CRNA (PRESIDENT)
(757) 892-4265
Entity
Organization
Contact information
Practice address
208 CARMICHAEL WAY, CHESAPEAKE, VA 23322-2183
(888) 209-0305
(952) 442-3688
Mailing address
400 10TH ST E, WACONIA, MN 55387-4552
(888) 209-0305
(952) 442-3688
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
10/29/2019
Last updated
01/07/2020
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