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General NPI Number Information
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NPI Number | 1548304561
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Entity Type | Individual
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Provider Name | GARY ROY GERMANN CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 01/25/2023
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Provider Practice Location Address
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Address Line | 128 BUCKSPORT RD STE A
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City | ELLSWORTH
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State | ME
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Zip | 04605-2239
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Country | US
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Telephone | 207-667-6300
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Fax |
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Provider Business Mailing Address
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Address Line | 232 SOUTH ST
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City | BLUE HILL
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State | ME
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Zip | 04614-6122
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Country | US
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Telephone | 941-894-7799
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 195787
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License Number State | MA
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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 | RNA223059
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License Number State | ME
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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 | ARNP9308627
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License Number State | FL
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