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General NPI Number Information
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NPI Number | 1346826849
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Entity Type | Individual
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Provider Name | HEBA S ABAZID
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Gender | Female
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Dates
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Enumeration Date | 03/23/2021
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Last Update Date | 10/06/2021
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Provider Practice Location Address
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Address Line | 25748 GRACELAND CIR
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48125-1067
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Country | US
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Telephone | 313-333-1364
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Fax |
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Provider Business Mailing Address
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Address Line | 25748 GRACELAND CIR
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48125-1067
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Country | US
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Telephone | 313-333-1364
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704326175NSA2107P
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 4704326175
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License Number State | MI
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