Healthcare Provider Details

I. General information

NPI: 1790783579
Provider Name (Legal Business Name): BARBARA ITHA ZVODAR CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 04/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VETERANS ADMINISTRATION MEDICAL CENTER 718 SMYTH ROAD
MANCHESTER NH
03104
US

IV. Provider business mailing address

29 DIANE MCCAIN RD
BRENTWOOD NH
03833-6125
US

V. Phone/Fax

Practice location:
  • Phone: 603-624-4366
  • Fax: 603-629-3253
Mailing address:
  • Phone: 603-642-7416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number32616
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: