Provider Demographics
NPI:1609855048
Name:POWELL, MICHAEL ALAN (CRNA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ALAN
Last Name:POWELL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-337-4168
Mailing Address - Fax:717-337-4318
Practice Address - Street 1:147 GETTYS ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-2534
Practice Address - Country:US
Practice Address - Phone:717-337-4168
Practice Address - Fax:717-337-4318
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PARN349332L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered