Healthcare Provider Details

I. General information

NPI: 1871569350
Provider Name (Legal Business Name): MARCIA MELDA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 12/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S STATE ST BAYHEALTH MEDICAL CENTER/DEPT. OF ANESTHESIA
DOVER DE
19901-3530
US

IV. Provider business mailing address

119 W COMMERCE ST
SMYRNA DE
19977-1367
US

V. Phone/Fax

Practice location:
  • Phone: 302-744-7089
  • Fax: 302-735-3239
Mailing address:
  • Phone: 302-388-8989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberL60A00430
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9229864
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: