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General NPI Number Information
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NPI Number | 1336226422
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Entity Type | Individual
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Provider Name | NAIMA LATRIESE OGLETREE DNP, MSN, APRN, BC
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 2799 W GRAND BLVD # CFP-547
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City | DETROIT
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State | MI
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Zip | 48202-2608
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Country | US
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Telephone | 313-916-2702
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Fax | 313-916-2554
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Provider Business Mailing Address
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Address Line | 14955 TAYLOR BLVD
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City | LIVONIA
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State | MI
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Zip | 48154-4065
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Country | US
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Telephone | 734-266-2013
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Fax |
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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 | 4704208571
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License Number State | MI
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