Provider Demographics
NPI:1629374640
Name:MERRIFIELD, R CRAIG (CRNA)
Entity Type:Individual
Prefix:
First Name:R
Middle Name:CRAIG
Last Name:MERRIFIELD
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 STONE LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31639-5163
Mailing Address - Country:US
Mailing Address - Phone:229-220-6575
Mailing Address - Fax:
Practice Address - Street 1:413 STONE LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:GA
Practice Address - Zip Code:31639-5163
Practice Address - Country:US
Practice Address - Phone:229-220-6575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9277352367500000X
GARN172344367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered