Provider Demographics
NPI:1518942838
Name:TANGEDA, ARTI O (CRNA)
Entity Type:Individual
Prefix:
First Name:ARTI
Middle Name:O
Last Name:TANGEDA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ARTI
Other - Middle Name:
Other - Last Name:OHRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 37090
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3090
Mailing Address - Country:US
Mailing Address - Phone:703-295-9360
Mailing Address - Fax:703-295-9369
Practice Address - Street 1:2501 PARKERS LN
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-3209
Practice Address - Country:US
Practice Address - Phone:703-295-9360
Practice Address - Fax:703-295-9369
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165609367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00323745OtherRAILROAD MEDICARE
VAK142-0002OtherCARE FIRST 2005
VA139230OtherTRIGON
VA1518942838Medicaid
VA1518942838Medicaid
VAP00323745OtherRAILROAD MEDICARE