Healthcare Provider Details

I. General information

NPI: 1023374071
Provider Name (Legal Business Name): BARBARA J ELLIOTT CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 CAREW ST
SPRINGFIELD MA
01104-2377
US

IV. Provider business mailing address

271 CAREW ST ANESTHESIA DEPT
SPRINGFIELD MA
01104
US

V. Phone/Fax

Practice location:
  • Phone: 413-748-9000
  • Fax:
Mailing address:
  • Phone: 413-748-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number087448-23
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2275498
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: