Individual
JAYSON MARK MICHNOWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1116 VALLEY ROSE WAY, DURHAM, NC 27712-2994
(618) 420-5903
Mailing address
1116 VALLEY ROSE WAY, DURHAM, NC 27712-2994
(618) 420-5903
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
264937
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/01/2013
Last updated
11/21/2022
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