Healthcare Provider Details

I. General information

NPI: 1962249151
Provider Name (Legal Business Name): TAYLOR VRANISH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2024
Last Update Date: 07/13/2024
Certification Date: 07/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 E 10 MILE RD
CENTER LINE MI
48015-1168
US

IV. Provider business mailing address

6900 E 10 MILE RD
CENTER LINE MI
48015-1168
US

V. Phone/Fax

Practice location:
  • Phone: 586-248-5758
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: