Provider Demographics
NPI:1366112906
Name:TRAVELING CRNA LLC
Entity type:Organization
Organization Name:TRAVELING CRNA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNTUERTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-889-8558
Mailing Address - Street 1:6210 BRIAR CT
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5941
Mailing Address - Country:US
Mailing Address - Phone:443-889-8558
Mailing Address - Fax:
Practice Address - Street 1:5233 KING AVE STE 208
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-4003
Practice Address - Country:US
Practice Address - Phone:443-889-8558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty