Healthcare Provider Details

I. General information

NPI: 1871607341
Provider Name (Legal Business Name): PAUL VAL MEREDITH CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27182 COUNTY ROAD 37
WRAY CO
80758-9606
US

IV. Provider business mailing address

27182 COUNTY ROAD 37
WRAY CO
80758-9606
US

V. Phone/Fax

Practice location:
  • Phone: 970-332-4161
  • Fax:
Mailing address:
  • Phone: 970-332-4161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number126813
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number43-54984
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: