Individual
MICHAEL J ST.JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
801 W MAPLE ST, FARMINGTON, NM 87401-5630
(505) 609-2000
Mailing address
10 COMMERCE DR, NEW ROCHELLE, NY 10801-5253
(914) 637-2063
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
182483
CO
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA-01195
NM
Other
Enumeration date
02/08/2012
Last updated
05/10/2012
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