Basic Information
| Provider Information | |||||||||
| NPI: | 1447245733 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABRENICA | ||||||||
| FirstName: | EVA | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3998 FAIR RIDGE DRIVE | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220332921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7032959360 | ||||||||
| FaxNumber: | 7037669725 | ||||||||
| Practice Location | |||||||||
| Address1: | 3600 JOSEPH SIEWICK DRIVE | ||||||||
| Address2: | FAIR OAKS HOSPITAL | ||||||||
| City: | FAIRFAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7032959360 | ||||||||
| FaxNumber: | 7032959369 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2005 | ||||||||
| LastUpdateDate: | 04/03/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 8789 | TN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | 0024166978 | VA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
ID Information
| ID | Type | State | Issuer | Description | 261966 | 01 | ANTHEM BCBS | OTHER | 010296307 | 05 | VA | MEDICAID | P00377928 | 01 | VA | RAILROAD MEDICARE | OTHER | 1447245733 | 05 | VA | MEDICAID | 430025004 | 01 | RAILROAD MEDICARE | OTHER | 010296323 | 05 | VA | MEDICAID | 139180 | 01 | VA | ANTHEM | OTHER | K142-0002 | 01 | DC | CAREFIRST | OTHER | 00013859 | 01 | NHC CARE ADMINISTRATORS | OTHER | 010295807 | 05 | VA | MEDICAID |