Individual
MICHEAL WAYNE ELLENDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4150 NELSON RD STE A4, LAKE CHARLES, LA 70605-4169
(337) 540-6900
Mailing address
4150 NELSON RD STE A4, LAKE CHARLES, LA 70605-4169
(337) 540-6900
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP07167
LA
Other
Enumeration date
02/05/2013
Last updated
02/05/2013
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