Provider Demographics
NPI:1104204734
Name:ALDERSON, MARK (CRNA)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:ALDERSON
Suffix:
Gender:
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 HENSMITH RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NH
Mailing Address - Zip Code:03268-5307
Mailing Address - Country:US
Mailing Address - Phone:603-545-9723
Mailing Address - Fax:
Practice Address - Street 1:264 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2551
Practice Address - Country:US
Practice Address - Phone:603-224-3368
Practice Address - Fax:603-228-7268
Is Sole Proprietor?:No
Enumeration Date:2015-05-15
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0106567163W00000X
NH064668-21163W00000X
MARN2290561163W00000X, 367500000X
NH064668-23367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse