Healthcare Provider Details

I. General information

NPI: 1457460222
Provider Name (Legal Business Name): UAYE JULIET ABAI BSC, BSN, RN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 10/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6773 STONEBRIGE COURT
WEST BLOOMFIELD MI
48322
US

IV. Provider business mailing address

6773 STONEBRIDGE CT
WEST BLOOMFIELD MI
48322-3268
US

V. Phone/Fax

Practice location:
  • Phone: 313-330-0393
  • Fax: 248-855-5543
Mailing address:
  • Phone: 313-330-0393
  • Fax: 248-855-5543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number4704246909
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704246909
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: