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

Individual provider Certified Registered Nurse Anesthetist · NPI 1215510805

Jaclyn Marie Fontaine, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Royal Oak, Michigan. Qualified in 2023, 3 years ago. Practices with Northstar Anesthesia of Michigan III PLLC, a 567-clinician group. Licensed in Michigan.

Years since qualifying
3
Licensed in
MI
In the registry since
2021
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone: (248) 898-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 4704338036 (MI)

Record details

NPI number1215510805
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNA
Sole proprietorYes
NPI enumeratedApril 30, 2021
Last updated in NPPESMarch 12, 2024
Certification dateMarch 12, 2024

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Northstar Anesthesia Of Michigan Iii Pllc — 567 clinicians
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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