Healthcare Provider Details

I. General information

NPI: 1194643122
Provider Name (Legal Business Name): RANEEM KATO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5292 POND BLUFF DR
WEST BLOOMFIELD MI
48323-2442
US

IV. Provider business mailing address

5292 POND BLUFF DR
WEST BLOOMFIELD MI
48323-2442
US

V. Phone/Fax

Practice location:
  • Phone: 469-279-3171
  • Fax:
Mailing address:
  • Phone: 469-279-3171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704434018
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: