Individual
MARCUS EUGENE HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
101 W IRONWOOD DR STE 250, COEUR D ALENE, ID 83814-1415
(208) 765-8585
Mailing address
101 W IRONWOOD DR STE 250, COEUR D ALENE, ID 83814-1415
(208) 765-8585
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
625990
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA-902A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002958903
—
TX
01
—
050889
CRNA LICENSE
TX
05
—
1457939380
—
ID
01
—
625990
TEXAS STATE NURSE LICENSE
TX
01
—
89607U
BCBS
TX
01
—
P00719258
RAILROAD
TX
Enumeration date
09/06/2006
Last updated
04/29/2024
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