Healthcare Provider Details

I. General information

NPI: 1003731019
Provider Name (Legal Business Name): RHYZIANNE PIMENTAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11051 HALL RD STE 240
UTICA MI
48317-5742
US

IV. Provider business mailing address

42129 MAC RAE DR
STERLING HEIGHTS MI
48313-2565
US

V. Phone/Fax

Practice location:
  • Phone: 586-232-5855
  • Fax:
Mailing address:
  • Phone: 248-802-5569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number4704328458
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: