Basic Information
Provider Information
NPI: 1508294190
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VOYLES
FirstName: MICHAEL
MiddleName: WARREN
NamePrefix: MR.
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 320 WHITTINGTON PKWY
Address2: SUITE 301
City: LOUISVILLE
State: KY
PostalCode: 402224928
CountryCode: US
TelephoneNumber: 5026255584
FaxNumber: 5024262264
Practice Location
Address1: 320 WHITTINGTON PKWY
Address2: SUITE 301
City: LOUISVILLE
State: KY
PostalCode: 402224928
CountryCode: US
TelephoneNumber: 5026255584
FaxNumber: 5024262264
Other Information
ProviderEnumerationDate: 10/17/2013
LastUpdateDate: 03/23/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X28210010AINN Nursing Service ProvidersRegistered Nurse 
367500000X28210010AINY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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