Individual
RANDALYN KAYE MERRIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8100 NORTHLAND DR, MINNEAPOLIS, MN 55431
(952) 831-8742
(952) 831-1626
Mailing address
6465 WAYZATA BLVD, SUITE 315, ST LOUIS PARK, MN 55426-1728
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R1542842
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
814603900
—
MN
Enumeration date
07/15/2005
Last updated
06/13/2018
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