Healthcare Provider Details

I. General information

NPI: 1154378917
Provider Name (Legal Business Name): GERALD S LAIRD CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 TRANSALPINE RD
LINCOLN ME
04457-4222
US

IV. Provider business mailing address

7 TRANSALPINE RD
LINCOLN ME
04457-4222
US

V. Phone/Fax

Practice location:
  • Phone: 207-794-3321
  • Fax:
Mailing address:
  • Phone: 207-794-3321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR020963
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: