Provider Demographics
NPI:1053810697
Name:HODGE, ANNA SCHERBAKOVA (CRNA)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:SCHERBAKOVA
Last Name:HODGE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:YAROSLAVA
Other - Last Name:SCHERBAKOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5051
Practice Address - Country:US
Practice Address - Phone:804-628-6990
Practice Address - Fax:804-628-6932
Is Sole Proprietor?:No
Enumeration Date:2018-02-09
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024175750367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered