Individual
MAURA ANN CRESCENZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
157 W BROOKE LN, BLISSFIELD, MI 49228
(517) 486-2411
(517) 486-3967
Mailing address
157 W BROOKE LN, BLISSFIELD, MI 49228-8601
(517) 486-2411
(517) 486-3967
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
17682-NP
OH
363LF0000X
Family Nurse Practitioner
Primary
4704347832
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0139529
—
OH
05
—
1518341098
—
MI
01
—
M35150171
MI MEDICARE
MI
Enumeration date
07/15/2015
Last updated
11/03/2023
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