Timothy J Axelson, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Waterville, ME
NPI 1649219353 · NPPES record last updated Dec 18, 2013
Key facts
- NPI
- 1649219353
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 046902 (ME)
- Practice address
- 149 North St
Waterville, ME 04901-4974 - Phone
- (207) 622-1959
- Fax
- (207) 430-4007
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046902 | ME | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waterville Anesthesia Associates, P.a. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 046902 | ME | Yes |
Addresses
Primary practice location
149 North St
Waterville, ME 04901-4974
Mailing address
35 Medical Center Pkwy
Augusta, ME 04330-8160
Phone (207) 622-1959
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300250099 | Medicaid | ME |
Other providers in Waterville, ME
- Dylan Atkins
- Stephanie Marie Aucoin
- Alishia M Austin
- Carol S Austin
- Cynthia Austin
- Isaac Axtell
- Faith Ayepola
- Crystal Denice Aylward
- Deborah M Bachand
- Abigail Susan Bagley
All providers in Waterville, ME · Certified Registered Nurse Anesthetist in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.