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NPI Code Detail

MEDICARE: RACHAEL J ESBROOK CRNA

MEDICARE: RACHAEL J ESBROOK CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist4704130150MI

General Provider Information

NPI Number : 1225094873
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHAEL J ESBROOK CRNA
Provider Business Mailing Address
First Line : 21778 PICADILLY CIR
Second Line :
City : NOVI
State : MI
Zip : 48375-4793
Country : US
Telephone Number : 248-449-5329
Fax Number :
Provider Business Practice Location Address
First Line : 6245 INKSTER RD
Second Line :
City : GARDEN CITY
State : MI
Zip : 48135-4001
Country : US
Telephone Number : 734-458-3295
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2006
Last Update Date : 07/08/2007

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