Provider Demographics
NPI:1568499259
Name:GOICH, JANA RENE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:JANA
Middle Name:RENE
Last Name:GOICH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 FEDERAL ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-2820
Mailing Address - Country:US
Mailing Address - Phone:708-305-2173
Mailing Address - Fax:
Practice Address - Street 1:38 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2820
Practice Address - Country:US
Practice Address - Phone:708-305-2173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA255840 MA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJX1978Medicare PIN
MANA1008Medicare PIN
MANA100801Medicare PIN