MARISSA LYNETTE COMMODORE CRNA NPI 1881264356

NPI Information

  • NPI: 1881264356
  • Provider Name: MARISSA LYNETTE COMMODORE, CRNA
  • Classification: Nurse Anesthetist, Certified Registered - 367500000X
  • Entity Type: Individual
  • Address: 5357 WINDFERN CT
    STONE MOUNTAIN, GA
    ZIP 30088
  • Phone: (770) 875-3080

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NPI Details

Marissa Lynette Commodore, CRNA is a nurse anesthetist certified registered in Stone Mountain, GA with 3 years of experience. The provider is (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. Marissa Lynette Commodore, CRNA NPI is 1881264356. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5357 WINDFERN CT
STONE MOUNTAIN, GA
ZIP 30088-329
Phone: (770) 875-3080

The enumeration date for this NPI number is 6/28/2021 and was last updated on 5/23/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207L00000XAnesthesiologyRN264280GEORGIANo
2367500000XNurse Anesthetist, Certified RegisteredRN264280GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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