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NPI Code Detail

MEDICARE: JEFFREY J MICHEL CRNA

MEDICARE:   JEFFREY J MICHEL  CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist862871MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023069333
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY J MICHEL CRNA
Provider Business Mailing Address
First Line : PO BOX 1547
Second Line :
City : SEDALIA
State : MO
Zip : 65302-1547
Country : US
Telephone Number : 660-826-5960
Fax Number : 660-826-4852
Provider Business Practice Location Address
First Line : 427 HIGHWAY 51 N
Second Line :
City : BROOKHAVEN
State : MS
Zip : 39601-2350
Country : US
Telephone Number : 660-826-5960
Fax Number : 660-826-4852
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 11/09/2017

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Directions to “ JEFFREY J MICHEL CRNA” Practice Location

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