Healthcare Provider Details

I. General information

NPI: 1366865222
Provider Name (Legal Business Name): HEATHER SAITTA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2014
Last Update Date: 02/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 ANDERSON ST UNIT 4
BOSTON MA
02114-3653
US

IV. Provider business mailing address

42 ANDERSON ST UNIT 4
BOSTON MA
02114-3653
US

V. Phone/Fax

Practice location:
  • Phone: 508-496-0890
  • Fax:
Mailing address:
  • Phone: 508-496-0890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN280228
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: