Individual
NICHOLAS REBEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 460-7469
Mailing address
23305 LEIGHWOOD DR, WOODHAVEN, MI 48183-2773
(734) 624-3488
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704259964
MI
Other
Enumeration date
12/22/2014
Last updated
12/22/2014
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