Individual
MITCH P EWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8212 SUMMA AVE, BATON ROUGE, LA 70809-3421
(225) 769-4403
(225) 769-3842
Mailing address
7777 HENNESSY BLVD, STE 301, BATON ROUGE, LA 70808-0319
(225) 769-4403
(225) 769-3842
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN09663-AP06022
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN096643-AP06022
CRNA LIC
LA
Enumeration date
03/07/2010
Last updated
02/15/2019
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