Individual
STEPHANIE DIERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3601 W 13 MILE RD, 400 FSC - PCS, ROYAL OAK, MI 48073-6769
(248) 423-3144
Mailing address
3601 W 13 MILE RD, 400 FSC - PCS, ROYAL OAK, MI 48073-6769
(248) 423-3144
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704195298
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430F364420
BCBSM
MI
05
—
4404028
—
MI
Enumeration date
03/10/2006
Last updated
06/09/2011
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