Provider Demographics
NPI:1043685415
Name:FERRERA, MARCELL (CRNA)
Entity Type:Individual
Prefix:
First Name:MARCELL
Middle Name:
Last Name:FERRERA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MARCELL
Other - Middle Name:
Other - Last Name:BAHOURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:5301 EAST HURON RIVER DRIVE
Mailing Address - Street 2:PO BOX 995
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48106
Mailing Address - Country:US
Mailing Address - Phone:734-786-2317
Mailing Address - Fax:734-786-4977
Practice Address - Street 1:5301 MCAULEY DR
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1051
Practice Address - Country:US
Practice Address - Phone:734-712-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-10
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704281316163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse