Organization
MINDEN ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY POWELL CRNA (CEO)
(660) 826-5960
Entity
Organization
Contact information
Practice address
1 MEDICAL PLAZA PL, MINDEN, LA 71055-3330
(660) 826-5960
Mailing address
PO BOX 1547, SEDALIA, MO 65302-1547
(660) 826-5960
(660) 826-4852
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2488465
—
LA
Enumeration date
11/20/2018
Last updated
05/01/2020
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