Healthcare Provider Details

I. General information

NPI: 1578554176
Provider Name (Legal Business Name): ANN KATHLEEN SAUNDERS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 MAPLE ST SUITE C233A
DANVERS MA
01923-4065
US

IV. Provider business mailing address

480 MAPLE ST SUITE C233A
DANVERS MA
01923-4065
US

V. Phone/Fax

Practice location:
  • Phone: 978-304-8690
  • Fax: 978-304-8697
Mailing address:
  • Phone: 978-304-8690
  • Fax: 978-304-8697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number192603
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number101-0021994
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: