Provider Demographics
NPI:1831605344
Name:VEACH, KRISTINE ROSE (CRNA, MSN)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:ROSE
Last Name:VEACH
Suffix:
Gender:F
Credentials:CRNA, MSN
Other - Prefix:
Other - First Name:KRISTINE
Other - Middle Name:ROSE
Other - Last Name:HILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22523 CRANBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-4503
Mailing Address - Country:US
Mailing Address - Phone:586-484-1738
Mailing Address - Fax:
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?:No
Enumeration Date:2017-12-19
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704292916367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered