Healthcare Provider Details

I. General information

NPI: 1285581801
Provider Name (Legal Business Name): MONA MAKKI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5818 TERNES ST
DEARBORN MI
48126-2010
US

IV. Provider business mailing address

5818 TERNES ST
DEARBORN MI
48126-2010
US

V. Phone/Fax

Practice location:
  • Phone: 313-806-9695
  • Fax:
Mailing address:
  • Phone: 313-806-9695
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number4704384528
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: