Provider Demographics
NPI: | 1104034693 |
---|---|
Name: | BROWNING, MICHAEL CRAIG (CRNA) |
Entity type: | Individual |
Prefix: | MR |
First Name: | MICHAEL |
Middle Name: | CRAIG |
Last Name: | BROWNING |
Suffix: | |
Gender: | M |
Credentials: | CRNA |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 7687 |
Mailing Address - Street 2: | |
Mailing Address - City: | COLUMBIA |
Mailing Address - State: | MO |
Mailing Address - Zip Code: | 65205-7687 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 573-882-2259 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1 HOSPITAL DR |
Practice Address - Street 2: | |
Practice Address - City: | COLUMBIA |
Practice Address - State: | MO |
Practice Address - Zip Code: | 65212-0001 |
Practice Address - Country: | US |
Practice Address - Phone: | 573-882-2568 |
Practice Address - Fax: | 573-882-2226 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2007-05-18 |
Last Update Date: | 2007-12-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MO | 2006037991 | 367500000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
MO | 910084201 | Medicaid | |
MO | 794935 | Other | HEALTHLINK |
MO | 834750635 | Medicare PIN | |
MO | 834755236 | Medicare PIN | |
MO | 910084201 | Medicaid | |
MO | P00415517 | Medicare PIN |