Healthcare Provider Details

I. General information

NPI: 1811290612
Provider Name (Legal Business Name): MELANIE A SEARS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2010
Last Update Date: 08/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 E MARSHALL ST ANESTHESIOLOGY
RICHMOND VA
23298-5051
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 804-628-6990
  • Fax: 804-628-6932
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 Number0001173788
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: