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General NPI Number Information
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NPI Number | 1154167575
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Entity Type | Individual
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Provider Name | SOPHIA JANE POLEY DNP, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/04/2024
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 888 W BIG BEAVER RD STE 900
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City | TROY
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State | MI
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Zip | 48084-4771
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Country | US
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Telephone | 248-629-2880
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Fax | 248-319-6493
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Provider Business Mailing Address
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Address Line | 888 W BIG BEAVER RD STE 900
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City | TROY
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State | MI
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Zip | 48084-4771
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Country | US
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Telephone | 248-629-2880
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Fax | 248-319-6493
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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 | APRN.CNP.0036767
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704375644
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License Number State | MI
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