Provider Demographics
NPI:1306814140
Name:GROSCHEN, JANICE MARIE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:MARIE
Last Name:GROSCHEN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:JANICE
Other - Middle Name:MARIE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 93
Mailing Address - Street 2:
Mailing Address - City:UNDERHILL CENTER
Mailing Address - State:VT
Mailing Address - Zip Code:05490-0093
Mailing Address - Country:US
Mailing Address - Phone:802-899-3421
Mailing Address - Fax:
Practice Address - Street 1:111 COLCHESTER AVE
Practice Address - Street 2:FAHC-DEPARTMENT OF ANESTHESIOLOGY
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401
Practice Address - Country:US
Practice Address - Phone:802-847-2415
Practice Address - Fax:802-847-5324
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1010032240367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered