Individual
TERRY JEAN ATKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5260
(586) 573-5364
Mailing address
11800 E 12 MILE RD, WARREN, MI 48093-3472
(586) 573-5260
(586) 573-5364
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704188707
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TA188707
BLUE CROSS OF MI
MI
Enumeration date
02/27/2006
Last updated
07/08/2007
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