Healthcare Provider Details

I. General information

NPI: 1437605706
Provider Name (Legal Business Name): JANICE ZENIEWICZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 08/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 WEST 7 MILE RD
DETROIT MI
48203-1967
US

IV. Provider business mailing address

62 WEST 7 MILE RD
DETROIT MI
48203-1967
US

V. Phone/Fax

Practice location:
  • Phone: 313-893-6172
  • Fax:
Mailing address:
  • Phone: 313-893-6172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704160851
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: