Healthcare Provider Details

I. General information

NPI: 1295889327
Provider Name (Legal Business Name): DEBRA J. ROSSIE CNM, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29751 LITTLE MACK AVE SUITE B
ROSEVILLE MI
48066-6503
US

IV. Provider business mailing address

29751 LITTLE MACK AVE SUITE B
ROSEVILLE MI
48066-6503
US

V. Phone/Fax

Practice location:
  • Phone: 586-415-6200
  • Fax: 586-415-6217
Mailing address:
  • Phone: 586-415-6200
  • Fax: 586-415-6217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number4704124459
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: