Organization
HENRY FORD HEALTH MACOMB OAKLAND HOSPITAL
Active
Other names
St. John Macomb Hospital CRNAs
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CEBALT (DIRECTOR)
(313) 874-6764
Entity
Organization
Contact information
Practice address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5260
(586) 573-5364
Mailing address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5260
(586) 573-5364
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135863102
USDOL
MI
01
—
430E064630
BCBS
MI
01
—
7853578
AETNA
MI
01
—
AN500006
MCARE
MI
Enumeration date
06/16/2006
Last updated
03/12/2026
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