Paulina Tackett, CRNA | |
39363 Owendale Dr, Sterling Heights, MI 48310-2569 | |
(586) 883-2905 | |
Not Available |
Full Name | Paulina Tackett |
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Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 39363 Owendale Dr, Sterling Heights, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1780256719 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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367500000X | Nurse Anesthetist, Certified Registered | 4704338150 (Michigan) | Primary |
163W00000X | Registered Nurse | 4704338150 (Michigan) | Secondary |
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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Paulina Tackett, CRNA 4640 Sidney St, Shelby Township, MI 48317-2955 Ph: (586) 883-2905 | Paulina Tackett, CRNA 39363 Owendale Dr, Sterling Heights, MI 48310-2569 Ph: (586) 883-2905 |
Mr. Michael John Rakowski, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 12815 Leech Dr, Sterling Heights, MI 48312 Phone: 313-343-4766 | |
Victoria M Lonczynski, C.R.N.A Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 14500 Hall Rd, Sterling Heights, MI 48313 Phone: 586-247-6918 | |
Myraflor Sanchez, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 39849 Crystal Dr, Sterling Heights, MI 48310 Phone: 586-354-4102 | |
Mr. Henry Cortez Uban Ii, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 14500 Hall Rd, Sterling Heights, MI 48313 Phone: 586-247-4049 Fax: 586-263-2128 | |
Lisa Mueller, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5456 15 Mile Rd, Suite 101, Sterling Heights, MI 48310 Phone: 586-977-7246 | |
Ms. Sandra Scetta Dagenais, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 14500 Hall Rd, Sterling Heights, MI 48313 Phone: 586-247-2700 |