Provider Demographics
NPI:1205860913
Name:GARCIA, VINCENT B (APN, CRNA)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:B
Last Name:GARCIA
Suffix:
Gender:M
Credentials:APN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE MEDICAL CENTER DRIVE
Mailing Address - Street 2:DARTMOUTH HITCHCOCK - ANESTHESIOLOGY
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756
Mailing Address - Country:US
Mailing Address - Phone:603-650-5922
Mailing Address - Fax:
Practice Address - Street 1:ONE MEDICAL CENTER DRIVE
Practice Address - Street 2:DARTMOUTH HITCHCOCK - ANESTHESIOLOGY
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756
Practice Address - Country:US
Practice Address - Phone:603-650-5922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-313611363LF0000X, 367500000X
NH058522-23367500000X
NH058522-21163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH000366001OtherMEDICARE PTAN
OH2671461Medicaid
OHP00365319OtherMEDICARE RAILROAD
VT1014437Medicaid
NH000366001OtherMEDICARE PTAN
OHGANP21091Medicare UPIN
VT1014437Medicaid