Individual
MICAH JOHN MCRAE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
9127 W RUSSELL RD STE 110, LAS VEGAS, NV 89148-1253
(702) 878-0070
(702) 209-2064
Mailing address
PO BOX 840857, DALLAS, TX 75284-0857
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA000540
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760928568
—
NV
Enumeration date
01/17/2017
Last updated
10/18/2022
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