Jeffrey Merriam, CRNA | |
9645 Grove Cir N Ste 250, Maple Grove, MN 55369 | |
(763) 201-8191 | |
(763) 201-8192 |
Full Name | Jeffrey Merriam |
---|---|
Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 9645 Grove Cir N Ste 250, Maple Grove, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1487657847 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | R121082-8 (Minnesota) | Primary |
Entity Name | Anesthesia Associates, Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1104176205 PECOS PAC ID: 4284879701 Enrollment ID: O20130403000426 |
Mailing Address | Practice Location Address |
---|---|
Jeffrey Merriam, CRNA 9645 Grove Cir N Ste 250, Maple Grove, MN 55369-4466 Ph: (763) 201-8191 | Jeffrey Merriam, CRNA 9645 Grove Cir N Ste 250, Maple Grove, MN 55369 Ph: (763) 201-8191 |
Mrs. Kelly Rae Peterson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 9803 Vagabond Ln N, Maple Grove, MN 55311 Phone: 612-242-1341 | |
Gregory S Mellesmoen, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 9645 Grove Cir N Ste 250, Maple Grove, MN 55369 Phone: 763-201-8191 Fax: 763-201-8192 |