Individual
DR. ALEX MICHAEL WITCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, CRNA
Contact information
Practice address
307 PENNSYLVANIA AVE, CARTERVILLE, IL 62918
(256) 339-2637
Mailing address
307 PENNSYLVANIA AVE, CARTERVILLE, IL 62918
(256) 339-2637
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.453211
IL
207L00000X
Anesthesiology Physician
114630
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
2023043288
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114630
NBCRNA
—
Enumeration date
08/31/2017
Last updated
02/29/2024
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