Healthcare Provider Details

I. General information

NPI: 1013731199
Provider Name (Legal Business Name): NICOLE STROMBERG RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2024
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G3373 S SAGINAW ST
BURTON MI
48529-1244
US

IV. Provider business mailing address

G3373 S SAGINAW ST
BURTON MI
48529-1244
US

V. Phone/Fax

Practice location:
  • Phone: 810-406-4040
  • Fax:
Mailing address:
  • Phone: 810-406-4040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704228772
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: