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

Individual provider Registered Nurse · NPI 1134601586

Jennifer Modina Roque, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Detroit, Michigan. Graduated from Wayne State University School of Medicine in 2018, 8 years ago. Practices with Henry Ford Health St John Hospital, a 330-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
8
Trained at
Wayne State University School of Medicine
Licensed in
MI
In the registry since
2018
Specialties on file
2
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

22101 Moross
Detroit, MI 48236
Phone: (313) 343-4370
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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 4704231669 (MI)
Registered Nurse Taxonomy 163W00000X · Licence 4704231669 (MI)

Record details

NPI number1134601586
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNA
Sole proprietorNo
NPI enumeratedSeptember 2, 2018
Last updated in NPPESOctober 12, 2018

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolWAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated 2018 (8 years in practice)
Group practice Henry Ford Health St. John Hospital — 330 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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