Healthcare Provider Details

I. General information

NPI: 1942131198
Provider Name (Legal Business Name): LUIS MIGUEL FERREIRA CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 LAKE AVE N
WORCESTER MA
01655-0002
US

IV. Provider business mailing address

35 HARRINGTON AVE UNIT 5314
SHREWSBURY MA
01545-5290
US

V. Phone/Fax

Practice location:
  • Phone: 774-443-2381
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN10010602
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: