Healthcare Provider Details

I. General information

NPI: 1033496955
Provider Name (Legal Business Name): MARCELLI JADE G. CONTRERAS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2011
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26911 NORTHWESTERN HWY STE 530
SOUTHFIELD MI
48033-8425
US

IV. Provider business mailing address

26911 NORTHWESTERN HWY STE 530
SOUTHFIELD MI
48033-8425
US

V. Phone/Fax

Practice location:
  • Phone: 947-522-0037
  • Fax: 947-522-0038
Mailing address:
  • Phone: 947-522-0037
  • Fax: 947-522-0038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704202054
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704202054
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: