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Individual

MICAH TIMOTHY AMOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
300 N 7TH ST, BISMARCK, ND 58501-4439
(402) 717-4866
(402) 818-2088
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-9419

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R041434
SD
367500000X
Certified Registered Nurse Anesthetist
D150890
IA
367500000X
Certified Registered Nurse Anesthetist
Primary
R54023
ND

Other

Enumeration date
03/28/2018
Last updated
05/10/2023
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