Healthcare Provider Details

I. General information

NPI: 1639124670
Provider Name (Legal Business Name): NANCY MARIE MASON N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: NANCY MARIE KROL N.P.

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 WOODWARD HTS
FERNDALE MI
48220-3007
US

IV. Provider business mailing address

43800 GARFIELD RD SUITE 201
CLINTON TOWNSHIP MI
48038-1136
US

V. Phone/Fax

Practice location:
  • Phone: 248-543-4138
  • Fax: 248-543-4252
Mailing address:
  • Phone: 586-228-4652
  • Fax: 586-228-4520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number4704149798
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License Number4704149798
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: