Provider Demographics
NPI:1992751838
Name:BREZNYAK, CAROLINE E (CRNA)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:E
Last Name:BREZNYAK
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 1:77 WEBB COVE DR
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:ME
Mailing Address - Zip Code:04493
Mailing Address - Country:US
Mailing Address - Phone:207-732-6787
Mailing Address - Fax:
Practice Address - Street 1:TRANSALPINE DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:ME
Practice Address - Zip Code:04457
Practice Address - Country:US
Practice Address - Phone:207-794-3321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR129123-2367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered