Individual provider · Type 1 NPI
Punyacha Chuanchom Crocker, NP
Acute Care Nurse Practitioner · Ann Arbor, MI
NPI number
1801294020
Active
Practice location
1500 East Medical Center Drive, B1 Floor Taubman Center Recp Mos Room 126
Ann Arbor, MI 48109-5317
Mailing address
3621 South State Street, 700 Kms Place
Ann Arbor, MI 48108
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner Primary | 363LA2100X | 4704278307 (MI) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1801294020
Punyacha Chuanchom Crocker, NP's National Provider Identifier is 1801294020, issued on Dec 22, 2014. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Ann Arbor, MI. The record was last updated on Nov 28, 2016.