Provider Demographics
NPI:1558371690
Name:HARPER, MICHAEL (CRNA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HARPER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4957 CO. RD 150
Mailing Address - Street 2:
Mailing Address - City:DAWSON
Mailing Address - State:AL
Mailing Address - Zip Code:35963
Mailing Address - Country:US
Mailing Address - Phone:256-659-2236
Mailing Address - Fax:256-659-2230
Practice Address - Street 1:1716 EVA RD NE
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-6006
Practice Address - Country:US
Practice Address - Phone:800-277-8151
Practice Address - Fax:336-841-6217
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-021945367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered