Provider Demographics
NPI:1699072512
Name:ZAWISZA, BETHANY M (CRNA)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:M
Last Name:ZAWISZA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:288 W MUD PIKE
Mailing Address - Street 2:
Mailing Address - City:ROCKWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15557-6944
Mailing Address - Country:US
Mailing Address - Phone:724-433-4867
Mailing Address - Fax:301-723-4983
Practice Address - Street 1:115 BALTIMORE ST STE 200
Practice Address - Street 2:BOX 1571
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2301
Practice Address - Country:US
Practice Address - Phone:301-723-4965
Practice Address - Fax:301-723-4983
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR193597367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered