Individual
NICOLE RENEE TANTIPITHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1500 E MEDICAL CENTER DR, 1H247 UNIVERSITY HOSPITAL, ANN ARBOR, MI 48109-5048
(734) 936-4280
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
4704253054
MI
367500000X
Certified Registered Nurse Anesthetist
4704253054
MI
Other
Enumeration date
09/27/2010
Last updated
10/03/2019
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