Healthcare Provider Details

I. General information

NPI: 1841281219
Provider Name (Legal Business Name): MELISSA SOLIDAY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8681 EAGLE POINT BLVD
LAKE ELMO MN
55042-8628
US

IV. Provider business mailing address

6623 CHADWICK DR
SAVAGE MN
55378-4038
US

V. Phone/Fax

Practice location:
  • Phone: 651-735-0501
  • Fax: 651-735-1870
Mailing address:
  • Phone: 952-447-0182
  • Fax: 952-447-0182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP3194382
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: