Provider Demographics
NPI:1013142835
Name:CERTIFIED PERIOPERATIVE SERVICES LLC
Entity Type:Organization
Organization Name:CERTIFIED PERIOPERATIVE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VESNA
Authorized Official - Middle Name:MILICA
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP,CRNFA
Authorized Official - Phone:215-605-1748
Mailing Address - Street 1:211 SOUTH ST
Mailing Address - Street 2:# 230
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-2305
Mailing Address - Country:US
Mailing Address - Phone:215-605-1748
Mailing Address - Fax:
Practice Address - Street 1:2100 CYPRESS ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-6508
Practice Address - Country:US
Practice Address - Phone:215-605-1748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA00000163WM0705X, 163WR0006X
PA0000000363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No163WM0705XNursing Service ProvidersRegistered NurseMedical-SurgicalGroup - Single Specialty
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty