Healthcare Provider Details

I. General information

NPI: 1952384836
Provider Name (Legal Business Name): MARCIA GENEVA GNAGEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 OLD ROAD TO 9 ACRE COR
CONCORD MA
01742-4159
US

IV. Provider business mailing address

133 OLD ROAD TO 9 ACRE COR
CONCORD MA
01742-4159
US

V. Phone/Fax

Practice location:
  • Phone: 978-287-3162
  • Fax:
Mailing address:
  • Phone: 978-287-3162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4044402
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number036764-23-11
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number167337
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: