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NPI Code Detail

MEDICARE: LISA ANN MILETO CRNA

MEDICARE: LISA ANN MILETO 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 Anesthetist5469NC
2367500000XCertified Registered Nurse Anesthetist4704160785MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1430F364420OTHERMIBCBSM
241152OTHERMINBCRNA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710955042
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ANN MILETO CRNA
Provider Business Mailing Address
First Line : 2746 PINEVIEW TRL
Second Line :
City : BRIGHTON
State : MI
Zip : 48114-8890
Country : US
Telephone Number : 810-986-9711
Fax Number :
Provider Business Practice Location Address
First Line : 1701 SOUTH BLVD E STE 300
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-6120
Country : US
Telephone Number : 517-332-1200
Fax Number : 517-351-7122
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2006
Last Update Date : 10/16/2024

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Directions to “ LISA ANN MILETO CRNA” Practice Location

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