Healthcare Provider Details

I. General information

NPI: 1992247779
Provider Name (Legal Business Name): DAYNA BUITING AGNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2016
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5440 CORPORATE DR STE 400
TROY MI
48098-2645
US

IV. Provider business mailing address

5440 CORPORATE DR STE 400
TROY MI
48098-2645
US

V. Phone/Fax

Practice location:
  • Phone: 248-764-8736
  • Fax: 866-903-4000
Mailing address:
  • Phone: 248-764-8736
  • Fax: 866-903-4000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704284680
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: