Individual
MR. GREGORY P HUMBRACHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2980 SAROSSY LK, GRASS LAKE, MI 49240-9455
(269) 251-2117
Mailing address
2980 SAROSSY LK, GRASS LAKE, MI 49240-9455
(269) 251-2117
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704115485
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4635722
—
MI
Enumeration date
09/26/2006
Last updated
12/01/2016
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