Provider Demographics
NPI:1215072335
Name:CALLAHAN, BARBARA ANN (CRNA)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 MASCOMA STREET
Mailing Address - Street 2:ALICE PECK DAY MEMORIAL HOSPITAL
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766
Mailing Address - Country:US
Mailing Address - Phone:603-448-7410
Mailing Address - Fax:
Practice Address - Street 1:125 MASCOMA STREET
Practice Address - Street 2:ALICE PECK DAY MEMORIAL HOSPITAL
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766
Practice Address - Country:US
Practice Address - Phone:603-448-7410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0205992311367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30342122Medicaid
NH40Y004073NH02OtherANTHEM
VTORE1898Medicaid
VTORE1898Medicaid