Healthcare Provider Details

I. General information

NPI: 1811006935
Provider Name (Legal Business Name): JEANNE MARIE FRENCH CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 BEECH ST ANESTHESIA DEPT
HOLYOKE MA
01040-2223
US

IV. Provider business mailing address

119 MAXIMILIAN DR
GRANBY MA
01033-9468
US

V. Phone/Fax

Practice location:
  • Phone: 413-534-2845
  • Fax: 413-540-5053
Mailing address:
  • Phone: 413-323-4264
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number93469
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: