Healthcare Provider Details

I. General information

NPI: 1316280118
Provider Name (Legal Business Name): SANDRA ZIEMKIEIWICZ RN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SANDRA LUSZCZYNSKI RN

II. Dates (important events)

Enumeration Date: 03/29/2013
Last Update Date: 03/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 FULLER RD
ANN ARBOR MI
48105-2303
US

IV. Provider business mailing address

2215 FULLER RD
ANN ARBOR MI
48105-2303
US

V. Phone/Fax

Practice location:
  • Phone: 734-769-7100
  • Fax: 734-845-3261
Mailing address:
  • Phone: 734-769-7100
  • Fax: 734-845-3261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberRN-128351
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: