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Contact Information

KIMBERLY A MANZAROLI, CRNA
11800 E 12 MILE RD
WARREN, MI48093-3472
 Phone: 586-573-5260
 Fax: 586-573-5364
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
Indicates primary specialty

NPI Profile & details for KIMBERLY A MANZAROLI · (Female)

NPI Number 1013074491
Status Active
Credentials CRNA (Certified Registered Nurse Anesthetist)
Entity Individual
Enumeration date 01/03/2007
Last updated 07/08/2007 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4704127509
  • MI Medicaid 1905127
Hospital affiliation(s)
  • ST JOHN MACOMB-OAKLAND HOSPITAL-MACOMB CENTER - (Acute Care)
    11800 EAST TWELVE MILE ROAD
    WARREN, MI 48093
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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