Healthcare Provider Details

I. General information

NPI: 1780506253
Provider Name (Legal Business Name): AUBRAYLL LACLAYSHA HOWARD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25660 CHALMERS ST
ROSEVILLE MI
48066-3725
US

IV. Provider business mailing address

25660 CHALMERS ST
ROSEVILLE MI
48066-3725
US

V. Phone/Fax

Practice location:
  • Phone: 586-302-0404
  • Fax:
Mailing address:
  • Phone: 586-302-0404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704388740
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704388740
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number4704388740
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: