Provider Demographics
NPI:1558411124
Name:MCKNIGHT, GESELLE MEADER (CRNA)
Entity Type:Individual
Prefix:
First Name:GESELLE
Middle Name:MEADER
Last Name:MCKNIGHT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 N LEISURE WORLD BLVD APT 817
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-7620
Mailing Address - Country:US
Mailing Address - Phone:301-233-1939
Mailing Address - Fax:301-438-2772
Practice Address - Street 1:3200 N LEISURE WORLD BLVD APT 817
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-7620
Practice Address - Country:US
Practice Address - Phone:301-233-1939
Practice Address - Fax:301-438-2772
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1007266367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered