Individual
MRS. MARY BRYANT FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1250 E MARSHALL ST, ANESTHESIA CRNA, RICHMOND, VA 23298-5051
(804) 628-6990
(804) 628-6969
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024166045
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010068479
—
VA
01
—
250009545
RAILROAD MEDICARE
VA
01
—
P00479179
RAILROAD MEDICARE
VA
Enumeration date
08/30/2006
Last updated
06/25/2008
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