Healthcare Provider Details

I. General information

NPI: 1487522801
Provider Name (Legal Business Name): COLIN THRASHER RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT STREET
BOSTON MA
02114-2696
US

IV. Provider business mailing address

45 STUART ST APT 1305
BOSTON MA
02116-4753
US

V. Phone/Fax

Practice location:
  • Phone: 617-726-3030
  • Fax:
Mailing address:
  • Phone: 505-366-8724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95165685
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-77213
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN2376070
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: