Provider Demographics
NPI:1578639258
Name:LAROSS, PATRICIA A (CRNA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:LAROSS
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:PO BOX 60596
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89160-0596
Mailing Address - Country:US
Mailing Address - Phone:702-795-8808
Mailing Address - Fax:702-795-8809
Practice Address - Street 1:1785 E SAHARA AVE
Practice Address - Street 2:STE 320
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3733
Practice Address - Country:US
Practice Address - Phone:702-795-8808
Practice Address - Fax:702-795-8809
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0004367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCRNA29690Medicare ID - Type Unspecified
NVVWCHFFMedicare PIN