Provider Demographics
NPI:1558341446
Name:MULLER, CARRIE MICHELLE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:MICHELLE
Last Name:MULLER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:MICHELLE
Other - Last Name:FORRESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:828 HEALTHY WAY
Mailing Address - Street 2:SUITE 115
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7958
Mailing Address - Country:US
Mailing Address - Phone:757-495-8070
Mailing Address - Fax:
Practice Address - Street 1:828 HEALTHY WAY
Practice Address - Street 2:SUITE 115
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-7958
Practice Address - Country:US
Practice Address - Phone:757-495-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166944367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA014805V37Medicare PIN