Michael Raymond Imbleau, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704234499 Issued in MI

Practice address

1221 Pine Grove Ave
Port Huron, MI 48060-3511

Phone

(810) 989-3754

Fax

(810) 985-2633

NPI assigned

Nov 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Port Huron Hospital Crna Billing, LLC

  • Certified Registered Nurse Anesthetist
  • Port Huron, MI
  • NPI 1538455159

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295800449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603511",
            "telephone_number": "810-989-3754",
            "fax_number": "810-985-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 PINE GROVE AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603511",
            "telephone_number": "810-989-3754",
            "fax_number": "810-985-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMBLEAU",
        "first_name": "MICHAEL",
        "middle_name": "RAYMOND",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704234499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE LICENSE",
            "identifier": "4704234499",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Britnie Anne Husson
• Debora Lynne Hutchins, LLPC
• Kyu Hwang, M.D.
• Rebecca Hycki, LMSW
• Marina Ibrahim, MD
• Dawn Marie Iminski, LLMSW
• Impact
• Impact Services
• Incorporation to Maximize Personal Achievement With Community Training
• Incorporation to Maximize Personal Achievement With Community Training

• Certified Registered Nurse Anesthetist in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• 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.

Verify at the official NPI Registry.