Provider Demographics
NPI:1689804205
Name:VROMAN, ALISA MAE (CRNA)
Entity Type:Individual
Prefix:
First Name:ALISA
Middle Name:MAE
Last Name:VROMAN
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 1:19 RIDGEWAY DR
Mailing Address - Street 2:
Mailing Address - City:BAR HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04609-7309
Mailing Address - Country:US
Mailing Address - Phone:660-287-7977
Mailing Address - Fax:
Practice Address - Street 1:1365 BROADWAY
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-2401
Practice Address - Country:US
Practice Address - Phone:207-942-6226
Practice Address - Fax:207-992-2756
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ252255367500000X
MO2002015923367500000X
MERNA183050367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered