Provider Demographics
NPI:1609885672
Name:YARAS, SUZANNE A (CRNA)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:A
Last Name:YARAS
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 1:13523 BARRETT PARDWAY DRIVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63021-3802
Mailing Address - Country:US
Mailing Address - Phone:636-938-6868
Mailing Address - Fax:636-938-1486
Practice Address - Street 1:1110 PROFESSIONAL COURT
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5826
Practice Address - Country:US
Practice Address - Phone:240-420-5559
Practice Address - Fax:240-420-3786
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR100077207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology