Healthcare Provider Details

I. General information

NPI: 1447077425
Provider Name (Legal Business Name): DEBRA A STREETMAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2512 HARTE DR
BRIGHTON MI
48114-7002
US

IV. Provider business mailing address

3572 BOWEN RD
HOWELL MI
48855-7754
US

V. Phone/Fax

Practice location:
  • Phone: 810-229-9220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704344528
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: