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Melissa Marie Illig, CRNA

Nurse Anesthetist, Certified Registered in Boston, MA. Individual provider (NPI-1).

NPI number1629631007
StatusActive
Last updated in NPPESJul 8, 2019

Details

NPI
1629631007
Entity type
Individual (NPI-1)
Name
Melissa Marie Illig
Credential
CRNA
Sex
Female
Sole proprietor
No
Enumeration date
Apr 21, 2019
Last updated
Jul 8, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
367500000X Nurse Anesthetist, Certified RegisteredRN2268708MAYes
163W00000X Registered Nurse2268708MA

Practice location

300 Longwood Ave
Boston, MA 02115-5724

Phone 617-355-5000

Mailing address

300 Longwood Ave
Boston, MA 02115-5724

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