Healthcare Provider Details

I. General information

NPI: 1194276287
Provider Name (Legal Business Name): JOSEPH KARANJA FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2016
Last Update Date: 06/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 ELDON BAKER DR
FLINT MI
48507-1923
US

IV. Provider business mailing address

1810 BIG BEAR DR
OWOSSO MI
48867-9159
US

V. Phone/Fax

Practice location:
  • Phone: 810-213-1803
  • Fax: 810-744-1306
Mailing address:
  • Phone: 513-293-3759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number4704291580
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704291580
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: