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Individual

GREGORY L. MCMICHAEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4420
Mailing address
1218 N MAIN ST, PUEBLO, CO 81003-2828
(719) 543-7877
(719) 543-7882

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
175046
CO

Other

Enumeration date
06/22/2010
Last updated
06/22/2010
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