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General NPI Number Information
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NPI Number | 1437998812
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Entity Type | Organization
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Legal Business Name | SLEEPBIGJOHN
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Dates
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Enumeration Date | 05/23/2024
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 24 HOSPITAL LN
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City | CALAIS
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State | ME
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Zip | 04619-1329
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Country | US
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Telephone | 207-454-7521
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Fax |
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Provider Business Mailing Address
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Address Line | 24 HOSPITAL LN
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City | CALAIS
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State | ME
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Zip | 04619-1329
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Country | US
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Telephone | 207-454-7521
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Fax |
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Authorized Official
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Title or Position | NURSE ANESTHETIST
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Name | JOHN GERARD RUTTER
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Credential | CRNA
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Telephone | 856-294-8672
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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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