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NPI Code Detail

MEDICARE: MISS JESSICA MARIE GRZEBIEN CRNA

MEDICARE: MISS JESSICA MARIE GRZEBIEN CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist127750MA

General Provider Information

NPI Number : 1194361014
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JESSICA MARIE GRZEBIEN CRNA
Provider Business Mailing Address
First Line : 15 COLUMBIA DR
Second Line :
City : CUMBERLAND
State : RI
Zip : 02864-6606
Country : US
Telephone Number : 401-523-1911
Fax Number :
Provider Business Practice Location Address
First Line : 211 PARK ST
Second Line :
City : ATTLEBORO
State : MA
Zip : 02703-3137
Country : US
Telephone Number : 508-222-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2019
Last Update Date : 11/26/2019

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