Active NPI
Mercedes Katherine Brousseau, CRNA
- Certified Registered Nurse Anesthetist
- Detroit, MI
National Provider Identifier
1801963608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 4704134307
- Practice address
- 3990 John R
Harper University Hospital
Detroit, MI 48201 - Phone
- (313) 745-8521
- NPI assigned
- Nov 29, 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 | 4704134307 | MI | Primary |
Addresses
Primary practice location
3990 John R
Harper University Hospital
Detroit, MI 48201
Mailing address
6371 North Maple Road
Saline, MI 48176
Phone (734) 429-4483
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)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704134307 | MI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monroe Community Health Services | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Mercy Memorial Outpatient Surgery Center
- Certified Registered Nurse Anesthetist
- Monroe, MI
- NPI 1447206719
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801963608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6371 NORTH MAPLE ROAD",
"city": "SALINE",
"state": "MI",
"postal_code": "48176",
"telephone_number": "734-429-4483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3990 JOHN R",
"address_2": "HARPER UNIVERSITY HOSPITAL",
"city": "DETROIT",
"state": "MI",
"postal_code": "48201",
"telephone_number": "313-745-8521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROUSSEAU",
"first_name": "MERCEDES",
"middle_name": "KATHERINE",
"name_prefix": "Ms.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "4704134307",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, 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.