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NPI Code Detail

MEDICARE: OLIVIA AJJA CRNA

MEDICARE:   OLIVIA  AJJA  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 Anesthetist4704217534MI
2367500000XCertified Registered Nurse AnesthetistAPRN.CRNA.019926OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OA217534OTHERMIBLUE CROSS OF MI
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225138431
Entity Type Code : Individual
Provider Name (Legal Business Name) : OLIVIA AJJA CRNA
Provider Business Mailing Address
First Line : 2006 HOGBACK RD STE 5A
Second Line :
City : ANN ARBOR
State : MI
Zip : 48105-9750
Country : US
Telephone Number : 952-442-9770
Fax Number :
Provider Business Practice Location Address
First Line : 4235 SECOR RD
Second Line :
City : TOLEDO
State : OH
Zip : 43623-4299
Country : US
Telephone Number : 419-473-3561
Fax Number : 419-214-1979
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 05/15/2026

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