Healthcare Provider Details

I. General information

NPI: 1609414473
Provider Name (Legal Business Name): RUTH GRACE GARCIA SAYAS AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2019
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W GRAND BLVD
DETROIT MI
48202-2689
US

IV. Provider business mailing address

13430 E 13 MILE RD
WARREN MI
48088-3187
US

V. Phone/Fax

Practice location:
  • Phone: 313-916-7178
  • Fax: 313-916-4353
Mailing address:
  • Phone: 586-427-1351
  • Fax: 586-486-5669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number4704246819
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704246819
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: