Provider Demographics
NPI:1629134143
Name:PIEMONTE, MARY KAY (CRNA)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KAY
Last Name:PIEMONTE
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Gender:F
Credentials:CRNA
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Mailing Address - Street 1:208 E RIDGEVILLE BLVD
Mailing Address - Street 2:# 201
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-5219
Mailing Address - Country:US
Mailing Address - Phone:301-829-7683
Mailing Address - Fax:301-829-7694
Practice Address - Street 1:6355 WALKER LN
Practice Address - Street 2:200
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3245
Practice Address - Country:US
Practice Address - Phone:703-922-9501
Practice Address - Fax:703-922-5347
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA0024085115367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00B746A59Medicare ID - Type Unspecified