Individual
TIFFANY S CONSOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, 1H247 UNIVERSITY HOSPITAL, ANN ARBOR, MI 48109-5048
(734) 936-4280
(734) 936-9091
Mailing address
3621 SOUTH STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704295814
MI
367500000X
Certified Registered Nurse Anesthetist
COA.12174-NA
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386949626
—
MI
05
—
3128538
—
OH
01
—
H488771
MEDICARE PIN
OH
Enumeration date
01/18/2011
Last updated
11/03/2023
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