Provider Demographics
NPI:1639288772
Name:VERMES, RACHIE J (CRNA)
Entity Type:Individual
Prefix:
First Name:RACHIE
Middle Name:J
Last Name:VERMES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JUICHI
Other - Middle Name:
Other - Last Name:VERMES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 452317
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33345-2317
Mailing Address - Country:US
Mailing Address - Phone:954-838-2371
Mailing Address - Fax:954-851-1746
Practice Address - Street 1:271 CAREW STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104
Practice Address - Country:US
Practice Address - Phone:413-748-9058
Practice Address - Fax:413-748-9066
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA263460367500000X
MARN263460367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANA1117Medicare ID - Type Unspecified