KELLY N PETZ (NPI# 1033200027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033200027 |
| Entity Type | Individual |
| Full Name | KELLY N PETZ |
| Other Name | KELLY S NEVINS |
| Credential | CRNA |
| Practice Address |
1001 Sam Perry Blvd Fredericksburg VA 22401-4453 |
| Mailing Address |
23955 Mill Cove Rd California MD 20619-3576 |
| Practice Telephone | 8003944445 |
| Practice Fax Number | 7069550720 |
| Mailing Telephone | 3017371430 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2008-05-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 367500000X | Nurse Anesthetist, Certified Registered | 127961 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 367500000X | Nurse Anesthetist, Certified Registered | 0001191107 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1001 SAM PERRY BLVD |
| City | FREDERICKSBURG |
| State | VA |
| Zip Code | 22401-4453 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730185398 | Torrey Hawley | Nurse Anesthetist, Certified Registered | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2005-06-28 |
| 1023622529 | Jacob Dillon Gooden | Physician Assistant | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2020-09-02 |
| 1508478462 | Sabrina Brandi Cervantez | Registered Nurse | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2020-08-20 |
| 1275144297 | Emily Burger | Pharmacist | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2020-08-13 |
| 1144839762 | Briana Lafuria | Registered Nurse | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2020-07-29 |
| 1831724301 | Yaru Chen | Registered Nurse | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2020-03-05 |
| 1922631456 | Christopher Barnes | Registered Nurse | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2020-02-12 |
| 1649803172 | Richard L Derrick | Registered Nurse | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2020-02-12 |
| 1851930838 | Markia Stewart Dudley | Nurse Practitioner | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2019-12-23 |
| 1861030637 | Amalea Suzette Gray | Pharmacist | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2019-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992313415 | Amanda Dodd | Behavior Technician | 1411 Princess Anne, Fredericksburg, VA 22401 | 2020-07-21 |
| 1215567326 | Britteny Whitaker | Behavior Technician | 1411 Princess Ann, Fredericksburg, VA 22401 | 2020-01-17 |
| 1396389433 | Ashley Stanevich | Behavior Technician | 1411 Princess Anne Lane, Fredericksburg, VA 22401 | 2019-11-01 |
| 1265074231 | Anna Kelleher | Behavior Technician | 1411 Princess Anna St, Frericksburg, VA 22401 | 2019-10-11 |
| 1649824152 | Zaan Z Ali | Audiologist | 1708 Fall Hill Ave Suite 100, Fredericksburg, VA 22401 | 2019-08-01 |
| 1790342426 | Michael Williams Jr. | Physician Assistant | 411 B Park Hill Dr, Frederickburg, VA 22401 | 2019-05-29 |
| 1285290965 | Ann Damalie Namabiro | Behavior Technician | 1411 Princess Ann Street, Fredericksburg, VA 22401 | 2019-05-17 |
| 1922579630 | Primary and Urgent Care LLC | Family Medicine | Primary and Urgent Care LLC, 2306 Plank Road Ste 100, Fredericksburg, VA 22401 | 2018-12-07 |
| 1003323056 | Mariah Mazzariello | Behavior Technician | 1411 Princess Anne Stree, Fredericksburg, VA 22401 | 2017-12-29 |
| 1336655281 | Hina Zafar | Behavior Technician | 1411 Princess Anne St., Fredericksburg, VA 22401 | 2017-12-14 |
| Find all providers in zip 22401 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215904479 | Mary A Hardie | Nurse Anesthetist, Certified Registered | 415 S Washington St, Fredericksburg, TX 78624-4636 | 2006-03-07 |
| 1568462638 | Charles Cross | Nurse Anesthetist, Certified Registered | 206 W Windcrest St, Fredericksburg, TX 78624-4408 | 2005-07-29 |
| 1730185398 | Torrey Hawley | Nurse Anesthetist, Certified Registered | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2005-06-28 |
| 1801449889 | Matthew John Redman | Nurse Anesthetist, Certified Registered | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2019-07-19 |
| 1225597305 | Lyle Jeremy Jackson | Nurse Anesthetist, Certified Registered | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2019-03-18 |
| 1386152890 | Connie W Fu | Nurse Anesthetist, Certified Registered | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2018-01-18 |
| 1780191338 | Shawn Taylor Henson | Nurse Anesthetist, Certified Registered | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2018-01-04 |
| 1427449560 | Hazel Pickering-luttrell | Nurse Anesthetist, Certified Registered | 4600 Spotsylvania Pkwy, Fredericksburg, VA 22408-7762 | 2015-02-11 |
| 1851719025 | Gregory Shaun Wiggins | Nurse Anesthetist, Certified Registered | 1020 S State Highway 16, Fredericksburg, TX 78624-4471 | 2014-04-03 |
| 1003246752 | Melyssa Carroll Mooney | Nurse Anesthetist, Certified Registered | 1001 Sam Perry Blvd, Fredericksburg, VA 22401-4453 | 2013-11-16 |
| Find all providers in FREDERICKSBURG | ||||
| City | FREDERICKSBURG |
| Zip Code | 22401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.