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

Mrs. Tia Dominique Agboruche

Individual provider Registered Nurse · NPI 1013687029

Mrs. Tia Dominique Agboruche is a Certified Registered Nurse Anesthetist (CRNA) in Detroit, Michigan. Qualified in 2021, 5 years ago. Practices with Henry Ford Health Genesys Hospital, a 86-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan and Ohio.

Years since qualifying
5
Licensed in
MI, OH
In the registry since
2021
Specialties on file
3
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Practice location Address checks out

20418 Binder St
Detroit, MI 48234-1913
Phone: (313) 333-4038
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 410 W 10th Ave Fl 1, Columbus, OH 43210-1240 — (614) 293-8487

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 4704311021 (MI)
Registered Nurse Taxonomy 163W00000X · Licence 4704311021 (MI)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence APRN.CRNA.0021121 (OH)

Record details

NPI number1013687029
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 20, 2021
Last updated in NPPESOctober 7, 2024
Certification dateOctober 7, 2024

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Henry Ford Health Genesys Hospital — 86 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Detroit