Healthcare Provider Details

I. General information

NPI: 1366094864
Provider Name (Legal Business Name): CINDY MARIE CROSBY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32813 MIDDLEBELT ROAD STE G
FARMINGON HILLS MI
48334-1702
US

IV. Provider business mailing address

32813 MIDDLEBELT ROAD STE G
FARMINGON HILLS MI
48334-1702
US

V. Phone/Fax

Practice location:
  • Phone: 248-970-2835
  • Fax: 248-970-2836
Mailing address:
  • Phone: 248-970-2835
  • Fax: 248-970-2836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number4704285751
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704285751
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: