Healthcare Provider Details

I. General information

NPI: 1356450316
Provider Name (Legal Business Name): ELIZABETH ANN MCGINNIS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 LIBBEY PKWY SUITE 301
WEYMOUTH MA
02189-3118
US

IV. Provider business mailing address

163 LIBBEY PKWY STE 301
WEYMOUTH MA
02189-3137
US

V. Phone/Fax

Practice location:
  • Phone: 781-337-4224
  • Fax: 781-335-0429
Mailing address:
  • Phone: 781-337-4224
  • Fax: 781-335-0429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2260045
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1477765092
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number688
License Number StateID
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11040843
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: