Healthcare Provider Details

I. General information

NPI: 1851216816
Provider Name (Legal Business Name): TIFFANI STEENSON
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16001 W 9 MILE RD
SOUTHFIELD MI
48075-4818
US

IV. Provider business mailing address

16001 W 9 MILE RD
SOUTHFIELD MI
48075-4818
US

V. Phone/Fax

Practice location:
  • Phone: 248-849-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704364371
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: