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General NPI Number Information
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NPI Number | 1285258855
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Entity Type | Individual
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Provider Name | DOUG J BRICKEY DNP CRNA
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Gender | Male
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Dates
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Enumeration Date | 05/30/2020
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Last Update Date | 02/13/2026
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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 | 03756-1000
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Country | US
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Telephone | 603-650-5000
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Fax | 603-640-1228
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Provider Business Mailing Address
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Address Line | 913 N MAIN ST APT 502
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City | ROCKFORD
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State | IL
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Zip | 61103-7058
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Country | US
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Telephone | 815-299-1090
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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 | 209-021401
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License Number State | IL
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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 | 041417502
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 113211-23
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License Number State | NH
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