Healthcare Provider Details

I. General information

NPI: 1427479633
Provider Name (Legal Business Name): ANDREW N PALASSIS CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2013
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 BELLEFONTAINE AVE
LIMA OH
45804
US

IV. Provider business mailing address

951 COMMERCE PKWY STE 101
LIMA OH
45804-4040
US

V. Phone/Fax

Practice location:
  • Phone: 419-228-3335
  • Fax: 419-998-4514
Mailing address:
  • Phone: 419-998-4575
  • Fax: 419-998-4586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCOA.15483-NA
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704425680
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11031248
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: