| Jeffrey Merriam, CRNA | |
|
9645 Grove Cir N Ste 250, Maple Grove, MN 55369 | |
| (763) 201-8191 | |
| (763) 201-8192 |
| Full Name | Jeffrey Merriam |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 9645 Grove Cir N Ste 250, Maple Grove, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487657847 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R121082-8 (Minnesota) | Primary |
| Entity Name | Anesthesia Associates, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1104176205 PECOS PAC ID: 4284879701 Enrollment ID: O20130403000426 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey Merriam, CRNA 9645 Grove Cir N Ste 250, Maple Grove, MN 55369-4466 Ph: (763) 201-8191 | Jeffrey Merriam, CRNA 9645 Grove Cir N Ste 250, Maple Grove, MN 55369 Ph: (763) 201-8191 |
Mrs. Kelly Rae Peterson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 9803 Vagabond Ln N, Maple Grove, MN 55311 Phone: 612-242-1341 | |
Alison Marie Stanley, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 9162 Sycamore Ln N, Maple Grove, MN 55369 Phone: 651-269-4820 | |
Gregory S Mellesmoen, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 9645 Grove Cir N Ste 250, Maple Grove, MN 55369 Phone: 763-201-8191 Fax: 763-201-8192 |