Individual
MS. CRYSTAL ANNEQUA GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
690 CANTON ST, #325, WESTWOOD, MA 02090-2321
(781) 407-7771
Mailing address
22 ROOSEVELT AVE, CHICOPEE, MA 01013-2906
(413) 687-9425
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
284428
MA
367500000X
Certified Registered Nurse Anesthetist
284428
MA
367500000X
Certified Registered Nurse Anesthetist
Primary
92299
NC
Other
Enumeration date
10/08/2012
Last updated
10/28/2020
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