Healthcare Provider Details

I. General information

NPI: 1013816982
Provider Name (Legal Business Name): LILY WU RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2026
Last Update Date: 11/05/2026
Certification Date: 11/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 CHALLIS RD STE 1011
BRIGHTON MI
48116-9416
US

IV. Provider business mailing address

7500 CHALLIS RD STE 1011
BRIGHTON MI
48116-9416
US

V. Phone/Fax

Practice location:
  • Phone: 734-432-7634
  • Fax: 734-232-4965
Mailing address:
  • Phone: 734-432-7634
  • Fax: 734-232-4965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number4704231617
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: