Provider Demographics
NPI:1134492655
Name:SINGLETON, TODD WILLIAM (CRNA)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:WILLIAM
Last Name:SINGLETON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 PHEASANT RIDGE COURT
Mailing Address - Street 2:
Mailing Address - City:ORTONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48462-5100
Mailing Address - Country:US
Mailing Address - Phone:541-210-2876
Mailing Address - Fax:
Practice Address - Street 1:428 PHEASANT RIDGE CT
Practice Address - Street 2:
Practice Address - City:ORTONVILLE
Practice Address - State:MI
Practice Address - Zip Code:48462
Practice Address - Country:US
Practice Address - Phone:541-210-2876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704287333367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered