Healthcare Provider Details

I. General information

NPI: 1316809171
Provider Name (Legal Business Name): CARLA HOROTAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2731 PLYMOUTH RD
ANN ARBOR MI
48105-2427
US

IV. Provider business mailing address

2731 PLYMOUTH RD
ANN ARBOR MI
48105-2427
US

V. Phone/Fax

Practice location:
  • Phone: 734-210-1122
  • Fax:
Mailing address:
  • Phone: 734-210-1122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704362714
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: