Provider Demographics
NPI:1801929211
Name:LYNCH, TENAJA R (CRNA)
Entity type:Individual
Prefix:MRS
First Name:TENAJA
Middle Name:R
Last Name:LYNCH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:TENAJA
Other - Middle Name:R
Other - Last Name:LISKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:5855 BREMO RD
Mailing Address - Street 2:SUITE 100 N
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226
Mailing Address - Country:US
Mailing Address - Phone:804-288-6258
Mailing Address - Fax:804-673-1038
Practice Address - Street 1:5855 BREMO RD
Practice Address - Street 2:SUITE 100 NORTH
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1926
Practice Address - Country:US
Practice Address - Phone:804-288-6258
Practice Address - Fax:804-282-9921
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167263367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered