Provider Demographics
NPI:1154489169
Name:MCELROY, TERRY M (CRNA)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:M
Last Name:MCELROY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11931 EDDLESTON DR
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91326
Mailing Address - Country:US
Mailing Address - Phone:818-368-5576
Mailing Address - Fax:818-368-0532
Practice Address - Street 1:11931 EDDLESTON DR
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91326
Practice Address - Country:US
Practice Address - Phone:818-368-5576
Practice Address - Fax:818-368-0532
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWNA34772AMedicare PIN