Individual
VIRGINIA N MOURAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
CORNER BOREALIS AND EAST D STREET, TOK, AK 99780-0314
(907) 883-9839
(907) 883-9839
Mailing address
PO BOX 314, TOK, AK 99780-0314
(907) 883-9839
(907) 883-9839
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
55129
KS
367500000X
Certified Registered Nurse Anesthetist
CRNA00209
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
144923
BCBS OF KS
KS
05
—
200371520A
—
KS
01
—
P00056232
RR MEDICARE GROUP CQ2302
KS
Enumeration date
03/14/2006
Last updated
11/30/2022
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