Individual
MARK MCCLANAHAN
Active
Individual
MARK MCCLANAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
470212204
MI
367500000X
Certified Registered Nurse Anesthetist
D161495
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704212204
LICENSE
MI
01
—
MM212204
BLUE CROSS OF MI
MI
Enumeration date
12/23/2005
Last updated
08/31/2026
Update your record
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