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General NPI Number Information
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NPI Number | 1033344189
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Entity Type | Individual
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Provider Name | ROSANNE MARIE SKONIECZNY RN NP
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Gender | Female
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 468 CADIEUX RD
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City | GROSSE POINTE
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State | MI
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Zip | 48230-1507
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Country | US
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Telephone | 313-343-1605
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Fax | 313-343-1934
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Provider Business Mailing Address
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Address Line | 3601 W 13 MILE RD 400 FSC
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City | ROYAL OAK
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State | MI
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Zip | 48073-6712
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Country | US
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Telephone | 248-423-2410
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Fax | 248-423-2576
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704223222
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License Number State | MI
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