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1043251226

NPI Code Detail

MEDICARE: MICHELE HANNON CRNA

MEDICARE: MICHELE HANNON CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	053547-23-11	NH
2	367500000X	Certified Registered Nurse Anesthetist	RN266324L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2197483	OTHER	NH	CIGNA HEALTHCARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	40Y008318NH01	OTHER	NH	BLUE CROSS BLUE SHIELD
5	68381	OTHER	VT	BLUE CROSS BLUE SHIELD
6	P64615	OTHER	NH	HARVARD PILGRIM HEALTHCAR

General Provider Information

NPI Number	:	1043251226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE HANNON CRNA

Provider Business Mailing Address
First Line	:	600 SAINT JOHNSBURY RD
Second Line	:
City	:	LITTLETON
State	:	NH
Zip	:	03561-3442
Country	:	US
Telephone Number	:	603-444-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 SAINT JOHNSBURY RD
Second Line	:
City	:	LITTLETON
State	:	NH
Zip	:	03561-3442
Country	:	US
Telephone Number	:	603-444-9000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	08/30/2013

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Directions to “ MICHELE HANNON CRNA” Practice Location

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