Healthcare Provider Details

I. General information

NPI: 1093674855
Provider Name (Legal Business Name): ANGELA ROSE CUFFARO MSN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2026
Last Update Date: 01/19/2026
Certification Date: 01/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45721 NORTH AVE
MACOMB MI
48042-5239
US

IV. Provider business mailing address

45721 NORTH AVE
MACOMB MI
48042-5239
US

V. Phone/Fax

Practice location:
  • Phone: 586-453-6272
  • Fax:
Mailing address:
  • Phone: 586-453-6272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License NumberNA
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: