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NPI Code Detail

MEDICARE: NORTHWEST HOUSECALL DOCTOR & NURSE PRACTITIONERS

MEDICARE: NORTHWEST HOUSECALL DOCTOR & NURSE PRACTITIONERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health AgencyMI

General Provider Information

NPI Number : 1083631725
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHWEST HOUSECALL DOCTOR & NURSE PRACTITIONERS
Provider Business Mailing Address
First Line : PO BOX 250463
Second Line :
City : FRANKLIN
State : MI
Zip : 48025-0463
Country : US
Telephone Number : 248-218-1198
Fax Number : 248-218-1888
Provider Business Practice Location Address
First Line : 9600 DEXTER AVE
Second Line :
City : DETROIT
State : MI
Zip : 48206-1816
Country : US
Telephone Number : 313-623-2813
Fax Number : 248-218-1888
Authorized Official
Title or Position : NURSE PRACTITIONER/PARTNER
Name : ANGELA L ROMAN
Credential : APRN, BC, FNP
Telephone Number : 248-218-1198
Provider Enumeration Date : 07/17/2006
Last Update Date : 01/09/2014

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Directions to “NORTHWEST HOUSECALL DOCTOR & NURSE PRACTITIONERS ” Practice Location

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