Basic Information
| Provider Information | |||||||||
| NPI: | 1124328067 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BRASSIL | ||||||||
| FirstName: | RHONDA | ||||||||
| MiddleName: | RHEAULT | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 372 | ||||||||
| Address2: | |||||||||
| City: | STOUGHTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 020720372 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7813413966 | ||||||||
| FaxNumber: | 7813418269 | ||||||||
| Practice Location | |||||||||
| Address1: | 91 MONTVALE AVE | ||||||||
| Address2: | C/O MA ANESTHESIA CORP | ||||||||
| City: | STONEHAM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021803623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7813413966 | ||||||||
| FaxNumber: | 7813418269 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2010 | ||||||||
| LastUpdateDate: | 10/26/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN216199 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.