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General NPI Number Information
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NPI Number | 1063324473
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Entity Type | Individual
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Provider Name | ANNA JEMIMA BONSRAH
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Gender | Female
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Dates
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Enumeration Date | 09/21/2026
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Last Update Date | 09/21/2026
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Provider Practice Location Address
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Address Line | 53 W MAPLE RD
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City | CLAWSON
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State | MI
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Zip | 48017-1109
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Country | US
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Telephone | 248-629-6084
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Fax | 248-629-6070
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Provider Business Mailing Address
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Address Line | 2534 PATRICK HENRY ST
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City | AUBURN HILLS
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State | MI
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Zip | 48326-2325
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Country | US
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Telephone | 248-707-9965
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Fax | 248-707-9965
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4704378618
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License Number State | MI
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