Healthcare Provider Details

I. General information

NPI: 1104236884
Provider Name (Legal Business Name): ANNE ELIZABETH BRENNAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE MURRAY

II. Dates (important events)

Enumeration Date: 05/02/2014
Last Update Date: 11/11/2020
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WASHINGTON ST
BOSTON MA
02111-1552
US

IV. Provider business mailing address

800 WASHINGTON ST
BOSTON MA
02111-1552
US

V. Phone/Fax

Practice location:
  • Phone: 617-636-5000
  • Fax:
Mailing address:
  • Phone: 617-636-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number101502
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN275918
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: