Nicole Thurman, | |
15324 Vaughan St, Detroit, MI 48223-1753 | |
(313) 549-1731 | |
Not Available |
Full Name | Nicole Thurman |
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Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 15324 Vaughan St, Detroit, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1417620865 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 4704303617 (Michigan) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 4704303617 (Michigan) | Primary |
Entity Name | Northstar Anesthesia Of Michigan Iii Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1972126209 PECOS PAC ID: 7911325469 Enrollment ID: O20200915001990 |
Mailing Address | Practice Location Address |
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Nicole Thurman, 15324 Vaughan St, Detroit, MI 48223-1753 Ph: (313) 549-1731 | Nicole Thurman, 15324 Vaughan St, Detroit, MI 48223-1753 Ph: (313) 549-1731 |
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