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General NPI Number Information
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NPI Number | 1063915312
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Entity Type | Organization
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Legal Business Name | MIRACLE CARING HANDS OF MICHIGAN LLC
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Dates
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Enumeration Date | 03/13/2018
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Last Update Date | 03/13/2018
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Provider Practice Location Address
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Address Line | 23219 DEMICK CT
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City | BROWNSTOWN
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State | MI
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Zip | 48134-6019
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Country | US
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Telephone | 734-775-2105
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Fax |
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Provider Business Mailing Address
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Address Line | 23219 DEMICK CT
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City | BROWNSTOWN
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State | MI
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Zip | 48134-6019
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Country | US
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Telephone | 734-775-2105
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Fax |
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Authorized Official
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Title or Position | DNP
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Name | DR. TORITSETSE CYNTHIA ANIEJURENGHO
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Credential | NURSE PRACTITIONER
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Telephone | 734-775-2105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 4704263570
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License Number State | MI
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