Individual
PRIDE TAWANDA MUDZWOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704317089
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704317089
NURSING LICENSE
MI
Enumeration date
01/08/2020
Last updated
01/09/2023
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