Organization
ST. JOSEPH MERCY HOSPITAL CRNA GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN J COOK CRNA (AUTHORIZED REPRESENTATIVE)
(248) 858-6593
Entity
Organization
Contact information
Practice address
44405 WOODWARD AVE, PONTIAC, MI 48341-5023
(248) 858-6593
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430F364410
BCN
MI
Enumeration date
07/05/2006
Last updated
06/18/2008
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