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General NPI Number Information
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NPI Number | 1437684743
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Entity Type | Organization
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Legal Business Name | LOWELL ANESTHESIA ASSOCIATES LLC
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Dates
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Enumeration Date | 04/24/2017
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Last Update Date | 04/24/2017
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Provider Practice Location Address
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Address Line | 59 LOWES WAY
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City | LOWELL
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State | MA
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Zip | 01851-5018
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Country | US
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Telephone | 978-349-2146
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Fax |
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Provider Business Mailing Address
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Address Line | 1A BURTON HILLS BLVD ATTN: PROVIDER ENROLLMENT
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City | NASHVILLE
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State | TN
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Zip | 37215-6187
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Country | US
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Telephone | 615-240-3809
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Fax | 615-234-1809
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Authorized Official
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Title or Position | PRESIDENT
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Name | PHILLIP CLENDENIN
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Credential |
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Telephone | 615-665-1283
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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 |
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License Number State |
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