Healthcare Provider Details

I. General information

NPI: 1427882703
Provider Name (Legal Business Name): ABBY G RUMSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ABBY G CORDOVA

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7445 ALLEN RD STE 270
ALLEN PARK MI
48101-1963
US

IV. Provider business mailing address

1032 E BRANDON BLVD STE 4567
BRANDON FL
33511-5509
US

V. Phone/Fax

Practice location:
  • Phone: 313-920-6546
  • Fax: 313-949-5793
Mailing address:
  • Phone: 201-474-5844
  • Fax: 877-804-1324

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704414166
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: