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Individual

MARK G ASMUSSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
312 GRAMMONT ST, SUITE 101, MONROE, LA 71201-7457
(318) 998-6138
(318) 998-6139
Mailing address
PO BOX 3185, MONROE, LA 71210-3185
(318) 998-6138
(318) 998-6139

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP02136
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1657646
LA
Enumeration date
02/15/2007
Last updated
01/23/2008
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