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Individual

MR. AUBREY FOLSOM MONCRIEF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
5470 STONE LEDGE CIR, OSAGE BEACH, MO 65065-2554
(573) 302-0836
(573) 302-0863
Mailing address
PO BOX 264, OSAGE BEACH, MO 65065-0264
(573) 302-0836
(573) 302-0863

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
084548
MO
367500000X
Certified Registered Nurse Anesthetist
209-001689
IL
367500000X
Certified Registered Nurse Anesthetist
4704131876
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
917422107
MO
Enumeration date
10/01/2006
Last updated
10/20/2008
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