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General NPI Number Information
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NPI Number | 1427020353
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Entity Type | Individual
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Provider Name | MELVIN MASIM VELASQUEZ CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 04/14/2024
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Provider Practice Location Address
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Address Line | 1224 TROTWOOD AVE
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City | COLUMBIA
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State | TN
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Zip | 38401-4802
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Country | US
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Telephone | 931-381-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 4230 HARDING PIKE STE 435
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City | NASHVILLE
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State | TN
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Zip | 37205-4900
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Country | US
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Telephone | 615-385-3704
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN118353
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 810498
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 11251
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License Number State | TN
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