Provider Demographics
NPI:1811006935
Name:FRENCH, JEANNE MARIE (CRNA)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:MARIE
Last Name:FRENCH
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 1:119 MAXIMILIAN DR
Mailing Address - Street 2:
Mailing Address - City:GRANBY
Mailing Address - State:MA
Mailing Address - Zip Code:01033-9468
Mailing Address - Country:US
Mailing Address - Phone:413-323-4264
Mailing Address - Fax:
Practice Address - Street 1:575 BEECH ST
Practice Address - Street 2:ANESTHESIA DEPT
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-2223
Practice Address - Country:US
Practice Address - Phone:413-534-2845
Practice Address - Fax:413-540-5053
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA93469367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJX2674OtherMEDICARE ID