Healthcare Provider Details

I. General information

NPI: 1295172435
Provider Name (Legal Business Name): BRIAN DARLING CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 05/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 MCAULEY DR ST. JOSEPH MERCY HOSPITAL ANN ARBOR
YPSILANTI MI
48197-1051
US

IV. Provider business mailing address

515 W LIBERTY ST APT. 3
ANN ARBOR MI
48103-4393
US

V. Phone/Fax

Practice location:
  • Phone: 734-712-3456
  • Fax:
Mailing address:
  • Phone: 734-276-5448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704264060
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: