Healthcare Provider Details

I. General information

NPI: 1538450812
Provider Name (Legal Business Name): BOBBIE KRZYWOZYCKI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2011
Last Update Date: 04/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 CARPENTER RD
ANN ARBOR MI
48108-4104
US

IV. Provider business mailing address

4800 BEMIS RD
YPSILANTI MI
48197-9375
US

V. Phone/Fax

Practice location:
  • Phone: 734-971-6300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number4704161840
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: