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General NPI Number Information
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NPI Number | 1629439104
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Entity Type | Individual
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Provider Name | MELISSA SUE GEROLIMATOS CRNA
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Gender | Female
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Dates
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Enumeration Date | 03/11/2016
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 416 GARDNER POINT DR
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City | STONY POINT
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State | NC
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Zip | 28678-9039
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Country | US
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Telephone | 616-260-1803
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Fax |
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Provider Business Mailing Address
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Address Line | 416 GARDNER POINT DR
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City | STONY POINT
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State | NC
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Zip | 28678-9039
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Country | US
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Telephone | 616-260-1803
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN2306307
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License Number State | MA
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