Basic Information
| Provider Information | |||||||||
| NPI: | 1467811299 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIRKEGAARD | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | GIULIANNA | ||||||||
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| Credential: | CRNA, RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10571 NW 24TH CT | ||||||||
| Address2: | |||||||||
| City: | SUNRISE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333222641 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9546088402 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1201 NW 16TH ST | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331251624 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055757000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2016 | ||||||||
| LastUpdateDate: | 02/17/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 110193 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.