Provider Demographics
NPI:1912981937
Name:PEDDREW, SHEILA JANICE (CRNA)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:JANICE
Last Name:PEDDREW
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8013 REMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2153
Mailing Address - Country:US
Mailing Address - Phone:410-336-4335
Mailing Address - Fax:
Practice Address - Street 1:20201 CENTURY BLVD
Practice Address - Street 2:CHEVY CHASE ANESTHESIA LLC SUITE 480
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1113
Practice Address - Country:US
Practice Address - Phone:301-515-4222
Practice Address - Fax:301-515-4153
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR039580367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00139387OtherRR MEDICARE
MD61389603KBCICHOtherBCBS MD
DC54170008OtherBCBS DC
MD61389603KBCICHOtherBCBS MD