Provider Demographics
NPI:1922197979
Name:KALAMARAS, MARY ANN (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ANN
Last Name:KALAMARAS
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 1:1163 COUNTRY CLUB ROAD
Mailing Address - Street 2:
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-1095
Mailing Address - Country:US
Mailing Address - Phone:724-258-1085
Mailing Address - Fax:724-258-1394
Practice Address - Street 1:1163 COUNTRY CLUB ROAD
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-1095
Practice Address - Country:US
Practice Address - Phone:724-258-1085
Practice Address - Fax:724-258-1394
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN146540L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAKA908146OtherBLUE SHIELD
PA314207OtherUPMC
PAKA908146OtherBLUE SHIELD