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General NPI Number Information
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NPI Number | 1093172595
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Entity Type | Individual
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Provider Name | ANA MARIE KOTSOGIANNIS CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/28/2016
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 22401 FOSTER WINTER DR
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City | SOUTHFIELD
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State | MI
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Zip | 48075-3724
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Country | US
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Telephone | 248-423-5198
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Fax |
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Provider Business Mailing Address
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Address Line | 3100 SPRING FOREST RD STE 130
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City | RALEIGH
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State | NC
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Zip | 27616-2880
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Country | US
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Telephone | 919-882-0705
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Fax | 919-873-9821
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 4704347058
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License Number State | VA
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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 | APN.0999380-CRNA
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 4704347058
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License Number State | MI
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