Individual
MICHAEL P ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
55 FOGG RD, WEYMOUTH, MA 02190-2432
(781) 624-8000
Mailing address
3645 SLAYTON AVE, NORTH PORT, FL 34286-4211
(401) 486-8969
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11011995
FL
367500000X
Certified Registered Nurse Anesthetist
213881
MA
Other
Enumeration date
08/02/2005
Last updated
12/09/2024
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