Healthcare Provider Details

I. General information

NPI: 1114351269
Provider Name (Legal Business Name): ANDREA L ERLEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA L BURRIER CRNA

II. Dates (important events)

Enumeration Date: 08/26/2013
Last Update Date: 07/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 CAMPUS AVE
LEWISTON ME
04240-6030
US

IV. Provider business mailing address

1613 N. HARRISON PARKWAY SUITE 200, MAILSTOP SH9A
SUNRISE FL
33323-2896
US

V. Phone/Fax

Practice location:
  • Phone: 207-777-8442
  • Fax: 207-777-8425
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 NumberRNA163007
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberL6-0A00744
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR185143
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: