Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carly Allyse Fardell

Individual provider Registered Nurse · NPI 1699507855

Carly Allyse Fardell is a Certified Registered Nurse Anesthetist (CRNA) in Southfield, Michigan. Qualified in 2024, 2 years ago. Practices with Henry Ford Health Providence Hospital, a 350-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
2
Licensed in
MI
In the registry since
2024
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Practice location Address checks out

16001 W 9 Mile Rd
Southfield, MI 48075-4818
Phone: (248) 849-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 170 N Caseville Rd, Pigeon, MI 48755-9704 — (989) 453-3223

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 4704322732 (MI)

Record details

NPI number1699507855
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 16, 2024
Last updated in NPPESAugust 16, 2024
Certification dateAugust 16, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Henry Ford Health Providence Hospital — 350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Southfield