Healthcare Provider Details

I. General information

NPI: 1124433313
Provider Name (Legal Business Name): DONNA SUE WESTMORELAND APRN, FNP-BC, ACHPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DONNA WESTMORELAND POMAVILLE APRN, FNP-BC, ACHPN

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 11/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16001 W 9 MILE RD
SOUTHFIELD MI
48075-4818
US

IV. Provider business mailing address

5864 LARKINS DR
TROY MI
48085-3877
US

V. Phone/Fax

Practice location:
  • Phone: 248-849-2265
  • Fax:
Mailing address:
  • Phone: 248-808-0778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704221204
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: