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NPI Code Detail

MEDICARE: ANDREW JAMES NOWALK CRNA

MEDICARE:   ANDREW JAMES NOWALK  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
1367500000XCertified Registered Nurse AnesthetistRN2371164MA

General Provider Information

NPI Number : 1154133163
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW JAMES NOWALK CRNA
Provider Business Mailing Address
First Line : 7B HORIZON DR
Second Line :
City : LONDONDERRY
State : NH
Zip : 03053-3785
Country : US
Telephone Number : 603-325-8608
Fax Number :
Provider Business Practice Location Address
First Line : 295 VARNUM AVE
Second Line :
City : LOWELL
State : MA
Zip : 01854-2134
Country : US
Telephone Number : 978-689-4601
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2025
Last Update Date : 05/23/2026

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Directions to “ ANDREW JAMES NOWALK CRNA” Practice Location

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