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General NPI Number Information
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NPI Number | 1043754914
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Entity Type | Individual
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Provider Name | MAGDALENA SOSNOWSKI GRNA
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Gender | Female
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Dates
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Enumeration Date | 12/13/2016
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Last Update Date | 07/02/2018
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Provider Practice Location Address
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Address Line | 47362 WHIPPOORWILL DR
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City | MACOMB
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State | MI
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Zip | 48044
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Country | US
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Telephone | 586-610-0385
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Fax |
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Provider Business Mailing Address
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Address Line | 47362 WHIPPOORWILL DR
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City | MACOMB
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State | MI
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Zip | 48044-5903
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 4704225668
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 4704225668
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License Number State | MI
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