Individual
MR. MICHAEL EDWARD KILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 883-5707
Mailing address
2100 HIGHWAY 61 N, VICKSBURG, MS 39183-8211
(601) 883-5707
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R864279
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08632573
—
MS
Enumeration date
01/23/2008
Last updated
08/25/2023
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