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NPI 1306211404

NPI 1306211404 : ERIK ZELISKI CRNA : GEORGETOWN, TN

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General NPI Number Information
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    NPI Number           |    1306211404
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    Entity Type          |    Individual 
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    Provider Name        |    ERIK ZELISKI CRNA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/01/2015
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    Last Update Date     |    11/03/2016
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Provider Practice Location Address
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    Address Line         |    7007 B AND K RANCH RD 
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    City                 |    GEORGETOWN
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    State                |    TN
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    Zip                  |    37336-4588
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    Country              |    US
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    Telephone            |    678-863-5921
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    410 N CEDAR BLUFF RD STE 300
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    City                 |    KNOXVILLE
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    State                |    TN
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    Zip                  |    37923-3632
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    Country              |    US
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    Telephone            |    865-342-8900
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    Fax                  |    865-691-0843
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    367500000X
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    Taxonomy Name        |    Certified Registered Nurse Anesthetist
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    License Number       |    21140
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    License Number State |    TN
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