Provider Demographics
NPI:1609301472
Name:PRANGE, REBECCA J (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:J
Last Name:PRANGE
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 1:2 LADDS WAY
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-1920
Mailing Address - Country:US
Mailing Address - Phone:781-424-8927
Mailing Address - Fax:
Practice Address - Street 1:2 LADDS WAY
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-1920
Practice Address - Country:US
Practice Address - Phone:781-424-8927
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA821720367500000X
MA283942367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered