Individual
PHAEDRIA THOROGOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1901 TATE SPRINGS RD, LYNCHBURG, VA 24501-1109
(276) 274-6137
Mailing address
609 ROTUNDA ST, LYNCHBURG, VA 24502-2073
(276) 274-6137
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0001207953
VA
367500000X
Certified Registered Nurse Anesthetist
0024171526
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821419177
—
NC
01
—
185RQ
BCBS
NC
Enumeration date
01/03/2014
Last updated
09/03/2022
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