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GREGORY S MELLESMOEN CRNA
NPI 1689633919
Nurse Anesthetist, Certified Registered in Maple Grove, MN

Active since March 23, 2006
9645 GROVE CIR N STE 250, MAPLE GROVE, MN 55369(763) 201-8191(763) 201-8192 Get Directions Write a Review

NPPES record last updated: June 13, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Gregory S Mellesmoen Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREGORY S MELLESMOEN CRNA (NPI 1689633919) is an individual nurse anesthetist, certified registered in Maple Grove, Minnesota, licensed in Minnesota (R0779700) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1689633919
Entity TypeIndividualMale
Primary Taxonomy367500000X
Provider Legal NameGREGORY S MELLESMOENCredential: CRNA
Location Address9645 GROVE CIR N STE 250Maple Grove, MN 55369
Mailing Address9645 Grove Cir N Ste 250Maple Grove, MN 55369-4466 · (763) 201-8191 · Fax (763) 201-8192
Phone(763) 201-8191
Fax(763) 201-8192
Sole ProprietorNo
Enumeration DateMarch 23, 2006
Last NPPES UpdateJune 13, 2018
✔ NPI 1689633919 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in MN · R0779700
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
9645 GROVE CIR N STE 250, Maple Grove, MN 55369
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Other Identifiers 1

Medicaid937843000MN

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANESTHESIA ASSOCIATES, PLLC
Specialist
9645 GROVE CIR N STE 250
MAPLE GROVE, MN 55369
Hennepin County (763) 201-8191
METROPOLITAN SURGICAL CENTER, LLC
Clinic/Center (Ambulatory Surgical)
9645 GROVE CIR N STE 250
MAPLE GROVE, MN 55369
Hennepin County (763) 201-8191
ALEXANDRA NICOLE KOES PA-C
Physician Assistant
9645 GROVE CIR N STE 250
MAPLE GROVE, MN 55369
Hennepin County (763) 201-8191
JEFFREY MERRIAM CRNA
Nurse Anesthetist, Certified Registered
9645 GROVE CIR N STE 250
MAPLE GROVE, MN 55369
Hennepin County (763) 201-8191

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gregory Mellesmoen's NPI number?

The NPI number for Gregory Mellesmoen is 1689633919. It was assigned to this individual provider in the NPPES registry on March 23, 2006.

Where is Gregory Mellesmoen located?

Gregory Mellesmoen practices at 9645 Grove Cir N Ste 250, Maple Grove, MN 55369. The listed phone number is (763) 201-8191.

What is Gregory Mellesmoen's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

When was this NPI record last updated?

The NPPES record for Gregory Mellesmoen was last updated on June 13, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.