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NPI Code Detail

MEDICARE: MR. STEPHEN EDWARD KUSHINER CRNA

MEDICARE: MR. STEPHEN EDWARD KUSHINER 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
1163WG0000XGeneral Practice Registered Nurse4704231646MI
2367500000XCertified Registered Nurse Anesthetist4704231646MI

General Provider Information

NPI Number : 1427240571
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEPHEN EDWARD KUSHINER CRNA
Provider Business Mailing Address
First Line : 100 MICHIGAN ST NE
Second Line : MC 845
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1840 WEALTHY ST SE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49506-2921
Country : US
Telephone Number : 616-774-7870
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2007
Last Update Date : 04/15/2026

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Directions to “ MR. STEPHEN EDWARD KUSHINER CRNA” Practice Location

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