Healthcare Provider Details

I. General information

NPI: 1306966346
Provider Name (Legal Business Name): CYNTHIA HELEN PIZANA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2007
Last Update Date: 06/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22101 MOROSS RD
DETROIT MI
48236
US

IV. Provider business mailing address

4825 E 10 MILE RD APT 128
WARREN MI
48091-1516
US

V. Phone/Fax

Practice location:
  • Phone: 313-343-7075
  • Fax:
Mailing address:
  • Phone: 313-303-4378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704226388
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704226388
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: