Healthcare Provider Details

I. General information

NPI: 1053127282
Provider Name (Legal Business Name): EMMA ROSE PITTERS RN, BSN, FNP, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: EMMA ROSE FOY

II. Dates (important events)

Enumeration Date: 12/03/2024
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E MEDICAL CENTER DR
ANN ARBOR MI
48109-5000
US

IV. Provider business mailing address

3621 S STATE ST
ANN ARBOR MI
48108-1633
US

V. Phone/Fax

Practice location:
  • Phone: 734-936-4000
  • Fax:
Mailing address:
  • Phone: 734-647-5299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704374650
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number884264
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1204107
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: