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General NPI Number Information
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NPI Number | 1861814238
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Entity Type | Individual
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Provider Name | THOMAS J GIANNACCINI III CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/20/2014
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | BROOKE ARMY MEDICAL CENTER 3551 ROGER BROOKE DRIVE
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234-4504
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Country | US
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Telephone | 210-539-9582
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 22487
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City | GREEN BAY
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State | WI
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Zip | 54305-2487
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Country | US
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Telephone | 920-445-7222
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Fax | 920-445-7289
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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 | 4704357139
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License Number State | MI
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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 | APRN9455337
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License Number State | FL
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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 | 675906
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RNA193038
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License Number State | ME
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