Provider Demographics
NPI:1326002320
Name:MESEROLL, BRIANA (CRNA)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:MESEROLL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:BRIANA
Other - Middle Name:
Other - Last Name:EXLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:804 GLEN ROCK RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502
Mailing Address - Country:US
Mailing Address - Phone:757-252-3147
Mailing Address - Fax:
Practice Address - Street 1:804 GLEN ROCK RD
Practice Address - Street 2:SUITE 200
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502
Practice Address - Country:US
Practice Address - Phone:757-252-3147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166426367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00X147V03Medicare PIN