Individual
MICHAEL JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 W 10TH ST, ROLLA, MO 65401-2905
(573) 458-8899
Mailing address
1000 W 10TH ST, ROLLA, MO 65401-2905
(573) 458-8899
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2014021951
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2014021951
LICENSE
MO
Enumeration date
08/26/2014
Last updated
08/26/2014
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