Healthcare Provider Details

I. General information

NPI: 1245217132
Provider Name (Legal Business Name): PATRICIA J AUGER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 SUMMER STREETR SUITE 255
WORCESTER MA
01608
US

IV. Provider business mailing address

123 SUMMER ST SUITE 255
WORCESTER MA
01608-1216
US

V. Phone/Fax

Practice location:
  • Phone: 508-363-6030
  • Fax: 508-363-9395
Mailing address:
  • Phone: 508-363-6030
  • Fax: 508-363-9395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRNA28300
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: