MEDICARE: MRS. TAMERA KAJY FNP-BC

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
1	363LF0000X	Family Nurse Practitioner	4704346544	MI

General Provider Information

NPI Number	:	1801516141
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAMERA KAJY FNP-BC

Provider Business Mailing Address
First Line	:	38049 LANCASTER DR
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48331-1756
Country	:	US
Telephone Number	:	248-756-3213
Fax Number	:

Provider Business Practice Location Address
First Line	:	811 SOUTH BLVD E STE 200
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-5359
Country	:	US
Telephone Number	:	248-651-0800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2022
Last Update Date	:	03/21/2023

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