Healthcare Provider Details

I. General information

NPI: 1184507907
Provider Name (Legal Business Name): MARIE-SOLEIL CHANTAL SAWKA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25000 HALL RD
WOODHAVEN MI
48183-5112
US

IV. Provider business mailing address

25000 HALL RD
WOODHAVEN MI
48183-5112
US

V. Phone/Fax

Practice location:
  • Phone: 734-675-1280
  • Fax:
Mailing address:
  • Phone: 734-675-1280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704406408
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: