Healthcare Provider Details

I. General information

NPI: 1639288772
Provider Name (Legal Business Name): RACHIE J VERMES CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JUICHI VERMES

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 03/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

271 CAREW STREET
SPRINGFIELD MA
01104
US

IV. Provider business mailing address

PO BOX 452317
SUNRISE FL
33345-2317
US

V. Phone/Fax

Practice location:
  • Phone: 413-748-9058
  • Fax: 413-748-9066
Mailing address:
  • Phone: 954-838-2371
  • Fax: 954-851-1746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number263460
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN263460
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: