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General NPI Number Information
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NPI Number | 1154955854
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Entity Type | Individual
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Provider Name | BRYNNE E RADEL CRNA
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Gender | Female
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Dates
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Enumeration Date | 03/03/2020
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | 326 WASHINGTON ST
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City | NORWICH
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State | CT
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Zip | 06360-2740
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Country | US
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Telephone | 860-933-6903
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Fax |
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Provider Business Mailing Address
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Address Line | 6 SABIN ST
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City | PUTNAM
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State | CT
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Zip | 06260-1842
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Country | US
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Telephone |
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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 | 127780
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License Number State | CT
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