Healthcare Provider Details

I. General information

NPI: 1457267460
Provider Name (Legal Business Name): GERALDDEAN DOW CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15660 LEE RD
ROCKWOOD MI
48173-9638
US

IV. Provider business mailing address

15660 LEE RD
ROCKWOOD MI
48173-9638
US

V. Phone/Fax

Practice location:
  • Phone: 734-749-5149
  • Fax:
Mailing address:
  • Phone: 734-749-5149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number900265888
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: