Individual provider Active NPI

Fatin Badran, CRNA

  • Certified Registered Nurse Anesthetist
  • Dearborn, MI
National Provider Identifier
1992242598
Registry record updated Jan 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704290473 Issued in MI
Practice address
15500 Lundy Pkwy
Dearborn, MI 48126-2778
Phone
(313) 586-5364
NPI assigned
Jan 21, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2017

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 4704290473 MI Primary

Addresses

Primary practice location

15500 Lundy Pkwy
Dearborn, MI 48126-2778

Mailing address

49977 Ash CT
Plymouth, MI 48170-6380
Phone (313) 258-7126

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

NPI Registry JSON

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

{
    "created_epoch": "1484956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484956800000",
    "number": "1992242598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49977 ASH CT",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481706380",
            "telephone_number": "313-258-7126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15500 LUNDY PKWY",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262778",
            "telephone_number": "313-586-5364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADRAN",
        "first_name": "FATIN",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-21",
        "last_updated": "2017-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704290473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2017; 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.