Healthcare Provider Details

I. General information

NPI: 1487908182
Provider Name (Legal Business Name): MELINDA M ZIMMER-RANKIN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2012
Last Update Date: 12/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 BREMO RD
RICHMOND VA
23226-1907
US

IV. Provider business mailing address

3100 SPRING FOREST RD SUITE 130
RALEIGH NC
27616-2880
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-6258
  • Fax: 804-673-1038
Mailing address:
  • Phone: 919-882-7908
  • Fax: 919-873-9821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0024174101
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: