Active NPI
Marie Lynne Van Til, DNP
- Certified Registered Nurse Anesthetist
- Cadillac, MI
National Provider Identifier
1548043128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 160015
- Practice address
- 400 Hobart St
Cadillac, MI 49601-2331 - Phone
- (231) 876-7200
- NPI assigned
- Aug 16, 2023
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | 4704308724 | MI | |
| Critical Care Medicine Registered Nurse | 163WC0200X | 359141 | NC | |
| Certified Registered Nurse Anesthetist | 367500000X | 160015 | MI | Primary |
Addresses
Primary practice location
400 Hobart St
Cadillac, MI 49601-2331
Mailing address
1363 Sandy Run Dr
Holland, MI 49424-5310
Phone (616) 566-9779
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 |
|---|---|---|---|
| 4704308724 | MI | MD | Critical Care Medicine Registered Nurse |
| 359141 | NC | MD | Critical Care Medicine Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787097600000",
"number": "1548043128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1363 SANDY RUN DR",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494245310",
"telephone_number": "616-566-9779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 HOBART ST",
"city": "CADILLAC",
"state": "MI",
"postal_code": "496012331",
"telephone_number": "231-876-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN TIL",
"first_name": "MARIE",
"middle_name": "LYNNE",
"credential": "DNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-16",
"last_updated": "2026-08-19",
"certification_date": "2026-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "MI",
"license": "4704308724",
"primary": false
},
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "NC",
"license": "359141",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "160015",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cadillac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.