Individual
MICHELLE M BALANCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-5806
(248) 849-5489
Mailing address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-5806
(248) 849-5489
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704168195
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11909375
CAQH
—
05
—
3392227
—
MI
01
—
F36455230
CRITTENTON MEDICARE PTAN
—
Enumeration date
09/14/2006
Last updated
01/18/2013
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