Provider Demographics
NPI:1467951871
Name:PATEL, NIA (CRNA)
Entity Type:Individual
Prefix:
First Name:NIA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:2006 HOGBACK RD, SUITE 5A
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:734-263-2395
Mailing Address - Fax:734-773-3471
Practice Address - Street 1:ST. JOSEPH MERCY OAKLAND HOSPITAL
Practice Address - Street 2:44405 WOODWARD AVE
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341
Practice Address - Country:US
Practice Address - Phone:248-585-3023
Practice Address - Fax:248-585-3022
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PARN648457367500000X
MI4704380364367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered