Individual
MICHAEL CHINNECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
900 PEELER ST, KALAMAZOO, MI 49008-2300
(269) 345-8618
Mailing address
900 PEELER ST, KALAMAZOO, MI 49008-2300
(269) 345-8618
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704289695
MI
367500000X
Certified Registered Nurse Anesthetist
28276094A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
4704289695
MI
390200000X
Student in an Organized Health Care Education/Training Program
227721
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1356884159
—
IN
01
—
4704289695
RN LICENSE - MICHGIAN
MI
Enumeration date
11/28/2016
Last updated
06/17/2025
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