Individual
KIMBERLY A MANZAROLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5260
(586) 573-5364
Mailing address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5260
(586) 573-5364
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704127509
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1905127
—
MI
Enumeration date
01/03/2007
Last updated
07/08/2007
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