Individual
MR. MICHAEL ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3109 BIENVILLE BLVD, OCEAN SPRINGS, MS 39564-4361
(228) 818-1111
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R787048
MS
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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