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General NPI Number Information
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NPI Number | 1336599752
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Entity Type | Individual
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Provider Name | MARY BOJANIC-HELENSKI
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Gender | Female
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Dates
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Enumeration Date | 06/16/2016
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Last Update Date | 06/16/2016
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Provider Practice Location Address
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Address Line | 15604 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48154-2852
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Country | US
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Telephone | 734-855-4176
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Fax | 734-855-4178
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Provider Business Mailing Address
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Address Line | 15604 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48154-2852
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Country | US
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Telephone | 734-855-4176
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Fax | 734-855-4178
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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 | 4704286882
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 4704286882
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License Number State | MI
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