Provider Demographics
NPI:1477507606
Name:THERRIEN, LORRAINE MARILYN (CRNA)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:MARILYN
Last Name:THERRIEN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LORRAINE
Other - Middle Name:MARILYN
Other - Last Name:SYNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:5900 BYRON CENTER AVE SW
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:MI
Mailing Address - Zip Code:49519-9606
Mailing Address - Country:US
Mailing Address - Phone:616-252-7200
Mailing Address - Fax:
Practice Address - Street 1:5900 BYRON CENTER AVE SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519-9606
Practice Address - Country:US
Practice Address - Phone:616-252-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9182361367500000X
IL041-300769367500000X
OHRN-271628367500000X
PAR-177926-L367500000X
MI4704211437367500000X
IN28135166A367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered