| Bernadette Galicia Canon, CRNA | |
|
3998 Fair Ridge Dr., Suite 320, Fairfax, VA 22033-2921 | |
| (703) 295-9360 | |
| (703) 295-9369 |
| Full Name | Bernadette Galicia Canon |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 18 Years |
| Location | 3998 Fair Ridge Dr., Fairfax, Virginia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528244514 | NPI | - | NPPES |
| 1528244514 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | 0001159170 (Virginia) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 0024167778 (Virginia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Stonesprings Hospital Center | Dulles, VA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Stonesprings Anesthesia Associates Ltd | 8921300971 | 22 |
| Entity Name | Stonesprings Anesthesia Associates Ltd |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1255718235 PECOS PAC ID: 8921300971 Enrollment ID: O20160107001130 |
| Entity Name | Old Dominion Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902248677 PECOS PAC ID: 8820462765 Enrollment ID: O20230316001226 |
| Mailing Address | Practice Location Address |
|---|---|
| Bernadette Galicia Canon, CRNA Po Box 37090, Baltimore, MD 21297-3090 Ph: (703) 295-9360 | Bernadette Galicia Canon, CRNA 3998 Fair Ridge Dr., Suite 320, Fairfax, VA 22033-2921 Ph: (703) 295-9360 |
Melissa K Hersch, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3600 Joseph Siewick Dr, Fairfax, VA 22033 Phone: 703-391-3129 | |
Kaley Lanzetta, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 3600 Joseph Siewick Dr, Fairfax, VA 22033 Phone: 703-391-3129 Fax: 703-391-3006 | |
Kelsey Schulman, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3998 Fair Ridge Dr, Suite 320, Fairfax, VA 22033 Phone: 703-295-9360 Fax: 703-295-9369 | |
Mr. Ahmed Rauf Qureshi, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3998 Fair Ridge Dr, Suite 320, Fairfax, VA 22033 Phone: 703-293-9590 Fax: 703-295-9369 | |
Ms. Christine B Culhane, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 3600 Joseph Siewick Dr, Fairfax, VA 22033 Phone: 703-295-9360 Fax: 703-295-9369 | |
Mr. Timothy J Rathbun, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 3600 Joseph Siewick Dr, Fairfax, VA 22033 Phone: 703-295-9360 Fax: 703-295-9369 | |
Ms. Carmen Smith, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3600 Joseph Siewick Dr, Fairfax, VA 22033 Phone: 703-295-9360 Fax: 703-295-9369 |