Individual provider Active NPI

Athena Elena Lievense, CRNA

  • Certified Registered Nurse Anesthetist
  • Fenton, MI
National Provider Identifier
1184465411
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704362950 Issued in MI
Practice address
413 Georgetown Pkwy
Fenton, MI 48430-3219
Phone
(517) 375-7068
NPI assigned
Jun 3, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704362950 MI Primary

Addresses

Primary practice location

413 Georgetown Pkwy
Fenton, MI 48430-3219

Mailing address

413 Georgetown Pkwy
Fenton, MI 48430-3219
Phone (517) 375-7068

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1184465411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 GEORGETOWN PKWY",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303219",
            "telephone_number": "517-375-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 GEORGETOWN PKWY",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484303219",
            "telephone_number": "517-375-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEVENSE",
        "first_name": "ATHENA",
        "middle_name": "ELENA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704362950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.