Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Owen Adolphsen

Individual provider Registered Nurse · NPI 1063241230

Owen Adolphsen is a Certified Registered Nurse Anesthetist (CRNA) in Petoskey, Michigan. Qualified in 2025, 1 year ago. Practices with Munson Medical Group, a 189-clinician group and accepts Medicare assignment. Licensed in Michigan and Pennsylvania.

Years since qualifying
1
Licensed in
MI, PA
In the registry since
2024
Specialties on file
2

Practice location Address checks out

416 Connable Ave
Petoskey, MI 49770-2212
Phone: (231) 348-2795
Fax: (231) 348-2031
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 4704351318 (MI)
Registered Nurse Taxonomy 163W00000X · Licence RN757422 (PA)

Record details

NPI number1063241230
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJuly 29, 2024
Last updated in NPPESJune 1, 2026
Certification dateJune 1, 2026
Mailing address602 Jackson St, Petoskey, MI 49770-2220

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Munson Medical Group — 189 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Petoskey