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General NPI Number Information
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NPI Number | 1326471764
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Entity Type | Individual
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Provider Name | TIMIKO LEI DREW NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 08/20/2013
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Last Update Date | 11/11/2022
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Provider Practice Location Address
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Address Line | 27177 LAHSER RD STE 201
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City | SOUTHFIELD
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State | MI
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Zip | 48034-8468
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Country | US
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Telephone | 248-895-8562
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Fax | 248-286-6255
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Provider Business Mailing Address
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Address Line | 220 MAIN SAIL CT
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City | DETROIT
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State | MI
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Zip | 48207-5008
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Country | US
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Telephone | 313-587-3087
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Fax | 248-286-6255
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 4704177492
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License Number State | MI
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