Individual
NICOLE A DIMUZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
22401 FOSTER WINTER DR, SOUTHFIELD, MI 48075-3724
(248) 423-5198
Mailing address
1000 HARRINGTON BLVD, MOUNT CLEMENS, MI 48043
(586) 493-8747
(586) 493-8741
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704216688
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4580796
—
MI
05
—
4601519
—
MI
Enumeration date
10/04/2006
Last updated
08/11/2025
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