Healthcare Provider Details

I. General information

NPI: 1336784594
Provider Name (Legal Business Name): HAMI KAREN CHABOYA APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2019
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47601 GRAND RIVER AVE
NOVI MI
48374-1233
US

IV. Provider business mailing address

2800 LIVERNOIS RD STE 500
TROY MI
48083-1219
US

V. Phone/Fax

Practice location:
  • Phone: 248-465-4311
  • Fax: 248-465-4651
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number4704260805
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number4704260805
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: