Healthcare Provider Details

I. General information

NPI: 1245150382
Provider Name (Legal Business Name): TAWANNA URQUHART
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20608 OLD HOMESTEAD DR
HARPER WOODS MI
48225-2039
US

IV. Provider business mailing address

20608 OLD HOMESTEAD DR
HARPER WOODS MI
48225-2039
US

V. Phone/Fax

Practice location:
  • Phone: 313-485-9450
  • Fax: 313-485-9450
Mailing address:
  • Phone: 313-485-9450
  • Fax: 313-485-9450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: