Individual
JOHN ABBOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4100 PARK FOREST DR, SUITE 210, TRAVERSE CITY, MI 49684
(231) 935-5770
(231) 935-0747
Mailing address
4100 PARK FOREST DR, SUITE 210, TRAVERSE CITY, MI 49684
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704185293
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104775376
—
MI
Enumeration date
04/22/2006
Last updated
03/23/2016
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