Provider Demographics
NPI:1386983088
Name:DELUCIA, ANNA MARIE (CRNA)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:DELUCIA
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 1:2692 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-1358
Mailing Address - Country:US
Mailing Address - Phone:203-458-2911
Mailing Address - Fax:
Practice Address - Street 1:2692 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-1358
Practice Address - Country:US
Practice Address - Phone:203-458-2911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5287367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered