Provider Demographics
NPI:1891777595
Name:PARRA, ANN MARIE (CRNA)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:MARIE
Last Name:PARRA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:MARIE
Other - Last Name:MOORHEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:29870 BOLINGBROKE LN
Mailing Address - Street 2:
Mailing Address - City:TRAPPE
Mailing Address - State:MD
Mailing Address - Zip Code:21673-1574
Mailing Address - Country:US
Mailing Address - Phone:410-382-9089
Mailing Address - Fax:
Practice Address - Street 1:1414 S SALISBURY BLVD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-7127
Practice Address - Country:US
Practice Address - Phone:410-749-1191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR089773367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD403898300Medicaid
MD403898300Medicaid