Provider Demographics
NPI:1285633594
Name:VASELICH, FELICIE F (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:FELICIE
Middle Name:F
Last Name:VASELICH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ANESTHESIA ASSOCIATES LTD
Mailing Address - Street 2:P.O. BOX 9203
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304
Mailing Address - Country:US
Mailing Address - Phone:703-931-2080
Mailing Address - Fax:703-845-7463
Practice Address - Street 1:INOVA ALEXANDRIA HOSPITAL
Practice Address - Street 2:4320 SEMINARY RD
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304
Practice Address - Country:US
Practice Address - Phone:703-931-2080
Practice Address - Fax:703-845-7463
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001040521207L00000X
VA0024040521207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000066A50Medicare ID - Type Unspecified