Divinagracia Juco, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704128866 Issued in MI

Practice address

1 William Carls Dr
Commerce Township, MI 48382-2201

Phone

(248) 937-3300

NPI assigned

Mar 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588784342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WILLIAM CARLS DR ANESTHESIA DEPARTMENT",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "48382",
            "telephone_number": "248-937-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WILLIAM CARLS DR",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483822201",
            "telephone_number": "248-937-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUCO",
        "first_name": "DIVINAGRACIA",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704128866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent Jenkins, D.D.S
• Lorrie Johnsen, ATC
• Carrie Jones, CRNA
• Samuel David Jonnalagadda, MD
• Jonott Enterprise
• Sarah Marie Kacic, P.T.
• Brittany Jean Kadrofske
• Jessica Abigail Kahn, PA-C
• Lori P Kaiser, OTR
• Victoria Kajbo, M.A., CCC-SLP

• Certified Registered Nurse Anesthetist in Commerce Township, MI
• Providers in Commerce Township, 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.