Glen Davis Anderson, crna
Nurse Anesthetist, Certified Registered in Lebanon, NH. Individual provider (NPI-1).
NPI number1245268366
StatusActive
Last updated in NPPESJan 12, 2012
Details
- NPI
- 1245268366
- Entity type
- Individual (NPI-1)
- Name
- Glen Davis Anderson
- Credential
- crna
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 29, 2006
- Last updated
- Jan 12, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 031334-23-11 | NH | Yes |
| 367500000X | Nurse Anesthetist, Certified Registered | 1010049041 | VT |
Practice location
1 Medical Center DrLebanon, NH 03756-1000
Phone 603-650-5922
Mailing address
1 Medical Center DrLebanon, NH 03756-1000
Phone 603-650-5922
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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