Healthcare Provider Details

I. General information

NPI: 1639601677
Provider Name (Legal Business Name): HANNAH ROSE BOIKE F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH ROSE BERMAN

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 01/06/2021
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39555 W. TEN MILE RD SUITE 302
NOVI MI
48375
US

IV. Provider business mailing address

39555 W. TEN MILE RD SUITE 302
NOVI MI
48375
US

V. Phone/Fax

Practice location:
  • Phone: 248-426-7200
  • Fax: 248-426-7335
Mailing address:
  • Phone: 248-426-7200
  • Fax: 248-426-7335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704324090
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: