Provider Demographics
NPI:1205904844
Name:GEHRET, MICHEAL ARDELL (CRNA)
Entity type:Individual
Prefix:MR
First Name:MICHEAL
Middle Name:ARDELL
Last Name:GEHRET
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 1:27070 COUNTY ROAD 37
Mailing Address - Street 2:
Mailing Address - City:WRAY
Mailing Address - State:CO
Mailing Address - Zip Code:80758-9606
Mailing Address - Country:US
Mailing Address - Phone:970-332-4044
Mailing Address - Fax:
Practice Address - Street 1:27070 COUNTY ROAD 37
Practice Address - Street 2:
Practice Address - City:WRAY
Practice Address - State:CO
Practice Address - Zip Code:80758-9606
Practice Address - Country:US
Practice Address - Phone:970-332-4044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO126766367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered