Individual ProviderKaley LanzettaNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3600 Joseph Siewick Dr, Fairfax, VA 22033-1709(703) 391-3129(571) 777-5100PECOS EnrollmentBased on the most recent information from CMS, provider Kaley Lanzetta does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:15 AM.Profile DetailsProvider ID1033583489Provider TypeIndividualFull NameLanzetta, KaleyCredentialCRNAGenderFemaleSole ProprietorYesEnumeration Date11/23/2015Last Updated1/14/2016Contact InformationPractice LocationPractice Address3600 Joseph Siewick Dr, Fairfax, VA 22033-1709Phone(703) 391-3129Fax(703) 391-3006Mailing LocationMailing Address11781 Lee Jackson Memorial Hwy, Suite 550, Fairfax, VA 22033-3309Phone(571) 777-5100Fax(703) 295-9369Provider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense0024173199Virginia