Active NPI
Estrellita G Lumbo, CRNA
- Certified Registered Nurse Anesthetist
- Wayne, MI
National Provider Identifier
1073690780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 4704088600
- Practice address
- 33155 Annapolis St
Wayne, MI 48184-2405 - Phone
- (734) 467-4667
- Fax
- (734) 467-2303
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 4704088600 | MI | Primary |
Addresses
Primary practice location
33155 Annapolis St
Wayne, MI 48184-2405
Mailing address
33155 Annapolis St
Wayne, MI 48184-2405
Phone (734) 467-4667
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4311617 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704088600 | MI | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073690780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33155 ANNAPOLIS ST",
"city": "WAYNE",
"state": "MI",
"postal_code": "481842405",
"telephone_number": "734-467-4667",
"fax_number": "734-467-2303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33155 ANNAPOLIS ST",
"city": "WAYNE",
"state": "MI",
"postal_code": "481842405",
"telephone_number": "734-467-4667",
"fax_number": "734-467-2303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUMBO",
"first_name": "ESTRELLITA",
"middle_name": "G",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "4704088600",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4311617",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wayne, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.