Provider Demographics
NPI:1326345083
Name:CHANG, ANNE JENKINS (MS, CRNA)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:JENKINS
Last Name:CHANG
Suffix:
Gender:F
Credentials:MS, CRNA
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:2014 WASHINGTON ST
Mailing Address - Street 2:DEPT. OF ANESTHESIOLOGY
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02462-1607
Mailing Address - Country:US
Mailing Address - Phone:617-243-6000
Mailing Address - Fax:617-243-6745
Practice Address - Street 1:2014 WASHINGTON ST
Practice Address - Street 2:DEPT. OF ANESTHESIOLOGY
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02462-1607
Practice Address - Country:US
Practice Address - Phone:617-243-6000
Practice Address - Fax:617-243-6745
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN262100367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered