Healthcare Provider Details

I. General information

NPI: 1669419735
Provider Name (Legal Business Name): SHARON BOLTON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 09/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 ST. JOHNSBURY RD.
LITTLETON NH
03561
US

IV. Provider business mailing address

PO BOX 160 PATIENT FINANCIAL SERVICES
LITTLETON NH
03561
US

V. Phone/Fax

Practice location:
  • Phone: 603-444-9000
  • Fax:
Mailing address:
  • Phone: 603-259-7627
  • Fax: 603-259-7561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number029981-23-11
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: