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General NPI Number Information
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NPI Number | 1326383100
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Entity Type | Individual
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Provider Name | KYLE C ANDERSON CRNA
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Gender | Male
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Dates
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Enumeration Date | 12/04/2012
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Last Update Date | 02/19/2018
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Provider Practice Location Address
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Address Line | 22 BRIDGE ST STE 9
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City | CONCORD
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State | NH
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Zip | 03301-4987
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Country | US
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Telephone | 603-415-0090
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Fax | 603-692-1817
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Provider Business Mailing Address
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Address Line | 7 WORKS WAY
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City | SOMERSWORTH
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State | NH
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Zip | 03878-1639
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Country | US
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Telephone | 603-841-2314
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Fax | 603-841-2305
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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 | 767058
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License Number State | CA
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