Individual
IVY LEE MERRIMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1300 MICCOSUKEE RD, TALLAHASSEE, FL 32308-5054
(850) 431-1155
Mailing address
2832 CRESTLINE RD, TALLAHASSEE, FL 32308-5081
(229) 254-0732
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11001028
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/19/2018
Last updated
08/12/2021
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