Healthcare Provider Details

I. General information

NPI: 1871747121
Provider Name (Legal Business Name): STEVEN CREAMER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2008
Last Update Date: 07/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 SUMMIT AVE
PROVIDENCE RI
02906-2853
US

IV. Provider business mailing address

690 CANTON ST SUITE 325
WESTWOOD MA
02090-2321
US

V. Phone/Fax

Practice location:
  • Phone: 401-793-4574
  • Fax:
Mailing address:
  • Phone: 781-407-7713
  • Fax: 781-407-0998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number278696
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN00564
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: