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General NPI Number Information
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NPI Number | 1215072202
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Entity Type | Individual
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Provider Name | JOHN MICHAEL BORZA CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 401 W GREENLAWN AVE
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City | LANSING
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State | MI
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Zip | 48910-2819
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Country | US
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Telephone | 517-334-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 1264 WOODHILL DR
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City | GIBSONIA
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State | PA
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Zip | 15044-9277
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Country | US
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Telephone | 724-444-6276
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 4704184059
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License Number State | MI
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