Healthcare Provider Details

I. General information

NPI: 1265518435
Provider Name (Legal Business Name): CECILIA PICCIO ESPINO BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CECILIA PAMA PICCIO BSN

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16001 W 9 MILE ROAD
SOUTHFIELD MI
48075
US

IV. Provider business mailing address

24158 WARNER ST
WARREN MI
48091
US

V. Phone/Fax

Practice location:
  • Phone: 248-849-3306
  • Fax: 248-849-5378
Mailing address:
  • Phone: 586-203-8373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH1000X
TaxonomyHospice Registered Nurse
License Number4704099953
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number4704099953
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number4704099953
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: