Provider Demographics
NPI:1477876688
Name:LAMBERT, TODD MARCUS (CRNA)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:MARCUS
Last Name:LAMBERT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 JESSIE RUN RD
Mailing Address - Street 2:
Mailing Address - City:RAVENSWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26164-6053
Mailing Address - Country:US
Mailing Address - Phone:319-660-0869
Mailing Address - Fax:
Practice Address - Street 1:401 MATTHEW ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-1635
Practice Address - Country:US
Practice Address - Phone:740-568-5427
Practice Address - Fax:740-376-5073
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAD147553367500000X
CT83709367500000X
OHAPRN.CRNA.0020658367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered