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General NPI Number Information
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NPI Number | 1114396975
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Entity Type | Individual
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Provider Name | CHRISTOPHER MANN CRNA
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Gender | Male
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Dates
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Enumeration Date | 09/22/2015
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DR
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City | LEBANON
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State | NH
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Zip | 03756-0001
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Country | US
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Telephone | 603-650-5000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4461
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City | SAINT JOHNSBURY
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State | VT
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Zip | 05819-4461
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Country | US
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Telephone | 802-342-4910
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 101.0115633
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 077575-23
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License Number State | NH
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