Individual
MARK MCCLANAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3271 W CARLETON RD, HILLSDALE, MI 49242-9458
(517) 797-4476
(517) 797-4478
Mailing address
PO BOX 411, OKEMOS, MI 48805-0411
(517) 797-4476
(517) 797-4478
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
470212204
MI
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
06/09/2023
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