Organization
LAKE SUPERIOR NURSE ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NICOLE STONE CRNA (OWNER)
(802) 989-2208
Entity
Organization
Contact information
Practice address
105 WESTVIEW RD STE 302, COLCHESTER, VT 05446-8025
(802) 497-3371
Mailing address
PO BOX 281, UNDERHILL, VT 05489-0281
(802) 497-3371
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
04/11/2017
Last updated
04/20/2017
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