Provider Demographics
NPI:1588660096
Name:CAPWELL, RAYMOND GEORGE JR (CRNA)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:GEORGE
Last Name:CAPWELL
Suffix:JR
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 1:10 FAUST CT
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-0010
Mailing Address - Country:US
Mailing Address - Phone:734-417-2702
Mailing Address - Fax:
Practice Address - Street 1:10 FAUST CT
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-0010
Practice Address - Country:US
Practice Address - Phone:734-417-2702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR122898-8163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse