Healthcare Provider Details
I. General information
NPI: 1316747207
Provider Name (Legal Business Name): CDS CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/18/2025
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
47370 BAKER ST
NOVI MI
48374-3669
US
IV. Provider business mailing address
47370 BAKER ST
NOVI MI
48374-3669
US
V. Phone/Fax
- Phone: 954-240-1251
- Fax:
- Phone: 954-240-1251
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CATHERINE
SIMEON
Title or Position: ADMINISTRATOR
Credential: NP
Phone: 954-240-1251