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NPI Code Detail

MEDICARE: KATHRYN GROECHEL CRNA, DNP

MEDICARE: KATHRYN GROECHEL CRNA, DNP
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 Anesthetist4704435643MI
2163W00000XRegistered Nurse041.477032IL

General Provider Information

NPI Number : 1972210847
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN GROECHEL CRNA, DNP
Provider Business Mailing Address
First Line : 1 FORD PL STE 3A
Second Line :
City : DETROIT
State : MI
Zip : 48202-3450
Country : US
Telephone Number : 313-874-4806
Fax Number : 313-876-1305
Provider Business Practice Location Address
First Line : 5841 S MARYLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60637-1443
Country : US
Telephone Number : 773-702-1522
Fax Number : 773-834-0694
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2022
Last Update Date : 02/06/2026

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