Provider Demographics
NPI:1770552929
Name:POWERS, CHERYL M (CRNA)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:M
Last Name:POWERS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:M
Other - Last Name:SWITZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:750 STEPHENSON HWY
Mailing Address - Street 2:BEAUMONT PAYOR CONTRACT SERVICES
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-1103
Mailing Address - Country:US
Mailing Address - Phone:248-577-3520
Mailing Address - Fax:
Practice Address - Street 1:3601 W 13 MILE RD
Practice Address - Street 2:ANESTHESIA
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6712
Practice Address - Country:US
Practice Address - Phone:248-577-3520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704155184367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2748914Medicaid
MI430F364420OtherBCBSM
MIR66185Medicare UPIN
MI2748914Medicaid