Healthcare Provider Details

I. General information

NPI: 1205875457
Provider Name (Legal Business Name): CHRISTOPHER COLLINS WELDON CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 GRAND ST
NEW BRITAIN CT
06052-2016
US

IV. Provider business mailing address

82 BEVERLY DR
AVON CT
06001-3528
US

V. Phone/Fax

Practice location:
  • Phone: 860-224-5266
  • Fax: 860-826-4992
Mailing address:
  • Phone: 860-675-4151
  • Fax: 860-673-9377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR34719
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number242394
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number534703-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: