Healthcare Provider Details

I. General information

NPI: 1801341821
Provider Name (Legal Business Name): BRIDGETTE DEFRANCE AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2016
Last Update Date: 11/16/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N WAYNE RD
WESTLAND MI
48185-3628
US

IV. Provider business mailing address

400 N WAYNE RD
WESTLAND MI
48185-3628
US

V. Phone/Fax

Practice location:
  • Phone: 734-522-7000
  • Fax: 734-522-7012
Mailing address:
  • Phone: 734-522-7000
  • Fax: 734-522-7012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number4704276382
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4704276382
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: