Canon, Bernadette Galicia

Canon, Bernadette Galicia is an individual health care provider with primary practice located at 3998 Fair Ridge Dr. Suite 320, Fairfax VA 22033-2921. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is her primary health care specialty. Canon, Bernadette Galicia can be contacted via phone (703) 295-9360.

Contact Information

Primary practice address
3998 Fair Ridge Dr. Suite 320 Fairfax VA 22033-2921
Phone: (703) 295-9360
Fax: (703) 295-9369
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 0001159170 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 0024167778 Virginia

Profile Details

NPI number 1528244514
LBN Legal business name Canon, Bernadette Galicia
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 21st, 2008
Last updated Mar 3rd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528244514 NPPES
Virginia MEDICAID 1528244514

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