Provider Demographics
NPI:1518274349
Name:METRO AREA SURGICAL ASSISTANTS, LLC
Entity Type:Organization
Organization Name:METRO AREA SURGICAL ASSISTANTS, LLC
Other - Org Name:MLP SURGICAL ASSISTING
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:CSA
Authorized Official - Phone:636-734-0386
Mailing Address - Street 1:289 FAIRWAY GREEN DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-4271
Mailing Address - Country:US
Mailing Address - Phone:636-734-0386
Mailing Address - Fax:
Practice Address - Street 1:289 FAIRWAY GREEN DR
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-4271
Practice Address - Country:US
Practice Address - Phone:636-734-0386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-31
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO143433163WR0006X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty
No251J00000XAgenciesNursing CareGroup - Single Specialty