Individual
SUSAN M FEYOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1850 TOWN CENTER PARKWAY, RESTON HOSPITAL CENTER, RESTON, VA 20190
(703) 471-0919
(703) 742-9081
Mailing address
PO BOX 2757, RESTON, VA 20195
(703) 471-0919
(703) 742-9081
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001173413
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024164710
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010042836
—
VA
01
—
P00218233
RAILROAD MEDICARE
—
Enumeration date
01/23/2006
Last updated
12/29/2010
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