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NPI 1982919825

NPI 1982919825 : KARL NESSI CRNA : BANGOR, ME

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General NPI Number Information
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    NPI Number           |    1982919825
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    Entity Type          |    Individual 
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    Provider Name        |    KARL NESSI CRNA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/16/2010
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    Last Update Date     |    01/17/2025
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Provider Practice Location Address
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    Address Line         |    360 BROADWAY 
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    City                 |    BANGOR
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    State                |    ME
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    Zip                  |    04401-3979
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    Country              |    US
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    Telephone            |    207-907-1000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT PO BOX 7291
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    City                 |    LEWISTON
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    State                |    ME
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    Zip                  |    04243-7291
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    Country              |    US
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    Telephone            |    207-777-8560
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    Fax                  |    207-777-8800
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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       |    95001418
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    License Number State |    CA
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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       |    RNA203025
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    License Number State |    ME
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