Individual
MR. MICHAEL P BLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3801 S NATIONAL AVE, SPRINGFIELD, MO 65807-5210
(417) 269-6000
Mailing address
1000 E PRIMROSE ST STE 520, SPRINGFIELD, MO 65807-5180
(417) 269-4550
(417) 269-4558
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1488082011
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
151168
MO
367500000X
Certified Registered Nurse Anesthetist
55054
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
918396300
—
MO
Enumeration date
03/01/2006
Last updated
12/30/2009
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