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Individual

GARY ALLEN HARLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
C.R.N.A.

Contact information

Practice address
211 SAINT FRANCIS DR, CAPE GIRARDEAU, MO 63703-5049
(573) 331-3000
(913) 341-5797
Mailing address
211 SAINT FRANCIS DR, CAPE GIRARDEAU, MO 63703-5049
(573) 331-3000
(913) 341-5797

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2002017914
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
105535
HEALTH ALLIANCE
MO
01
110375
HEALTH LINK
MO
01
405586
BCBS
MO
01
430079551
RAILROAD MEDICARE
MO
05
919026302
MO
01
A165
CHAMPUS TRICARE
MO
Enumeration date
04/10/2006
Last updated
06/25/2009
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