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NPI Code Detail

MEDICARE: DEBORAH MCWILLIAMS RN, CPNP

MEDICARE: DEBORAH MCWILLIAMS RN, CPNP
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
1363LP0200XPediatric Nurse Practitioner4704104666MI
2363L00000XNurse Practitioner4704104666MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114918232
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH MCWILLIAMS RN, CPNP
Provider Business Mailing Address
First Line : 24838 JAMESTOWNE RD
Second Line :
City : NOVI
State : MI
Zip : 48375-2278
Country : US
Telephone Number : 248-348-7971
Fax Number :
Provider Business Practice Location Address
First Line : 3901 BEAUBIEN ST
Second Line : DIVISION OF UROLOGY
City : DETROIT
State : MI
Zip : 48201-2119
Country : US
Telephone Number : 313-966-5371
Fax Number : 313-993-8738
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 04/13/2009

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