Provider Demographics
NPI:1982905741
Name:DANDANEAU, PATRICK M (CRNA)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:M
Last Name:DANDANEAU
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:760 PILOT HOUSE DR
Mailing Address - Street 2:STE B
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-2068
Mailing Address - Country:US
Mailing Address - Phone:757-591-2260
Mailing Address - Fax:757-595-2001
Practice Address - Street 1:2 BERNARDINE DR
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-4404
Practice Address - Country:US
Practice Address - Phone:757-591-2260
Practice Address - Fax:757-595-2001
Is Sole Proprietor?:No
Enumeration Date:2010-11-10
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024169058367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered