Individual
MATTHEW WARNER ELLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1906 BELLEVIEW AVE SE STE A, ROANOKE, VA 24014-1838
(540) 981-7000
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5353
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
286339
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
0024191721
VA
367500000X
Certified Registered Nurse Anesthetist
7204
NC
Other
Enumeration date
07/01/2021
Last updated
11/04/2024
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