Healthcare Provider Details

I. General information

NPI: 1750331344
Provider Name (Legal Business Name): MELVIN LEE ATCHISON CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 01/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 TRANCAS ST QUEEN OF THE VALLY HOSPITAL
NAPA CA
94558
US

IV. Provider business mailing address

PO BOX 6139,
NAPA CA
94581
US

V. Phone/Fax

Practice location:
  • Phone: 707-226-2901
  • Fax:
Mailing address:
  • Phone: 888-270-0340
  • Fax: 888-270-0331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN419471
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberNA1156
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: