Provider Demographics
NPI:1073096715
Name:MONTEIRO, DERRIANNE MICHELLE (DNP, CRNA)
Entity Type:Individual
Prefix:DR
First Name:DERRIANNE
Middle Name:MICHELLE
Last Name:MONTEIRO
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Gender:F
Credentials:DNP, CRNA
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Mailing Address - Street 1:2401 W UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-3428
Mailing Address - Country:US
Mailing Address - Phone:765-747-3111
Mailing Address - Fax:765-751-5087
Practice Address - Street 1:1421 N 7TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47807-1005
Practice Address - Country:US
Practice Address - Phone:812-231-4608
Practice Address - Fax:812-231-4675
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2020-09-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN28197746A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered