Healthcare Provider Details

I. General information

NPI: 1780622977
Provider Name (Legal Business Name): AMY E. ARNETT CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY E. SHAWAKER

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 FRANCIS ST
BOSTON MA
02115-6106
US

IV. Provider business mailing address

6344 E JAMISON CIR S
CENTENNIAL CO
80112-2417
US

V. Phone/Fax

Practice location:
  • Phone: 617-732-5500
  • Fax:
Mailing address:
  • Phone: 303-476-8661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN 4953
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP30006492
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN2351588
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: