Healthcare Provider Details

I. General information

NPI: 1881798494
Provider Name (Legal Business Name): CYNTHIA D COURTNEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 04/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 PROSPECT ST
NASHUA NH
03060-3925
US

IV. Provider business mailing address

68 S SERVICE RD SUITE 550
MELVILLE NY
11747-2354
US

V. Phone/Fax

Practice location:
  • Phone: 603-577-2000
  • Fax:
Mailing address:
  • Phone: 516-945-3115
  • Fax: 516-945-3131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP1590192
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberTLRN028057
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number062873-21
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: