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General NPI Number Information
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NPI Number | 1427055581
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Entity Type | Individual
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Provider Name | LORETTA MADDEN-HOLMAN CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/05/2005
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 11 WHITEHALL RD ANESTHESIA DEPARTMENT
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City | ROCHESTER
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State | NH
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Zip | 03867-3226
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Country | US
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Telephone | 603-335-8419
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Fax |
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Provider Business Mailing Address
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Address Line | 66 POWERHOUSE RD 3RD FLOOR
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City | ROSLYN HEIGHTS
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State | NY
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Zip | 11577-1324
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Country | US
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Telephone | 516-626-6366
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 0507212311
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License Number State | NH
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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 | RN2328063
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License Number State | MA
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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 | 101970-875
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License Number State | WI
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