Individual
BRIAN EELLS
Active
Individual
BRIAN EELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704213639
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104300972
—
MI
01
—
527892243
TRICARE
MI
01
—
BE213639
BLUE CROSS
MI
Enumeration date
08/26/2005
Last updated
08/25/2008
Update your record
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