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 |