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General NPI Number Information
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NPI Number | 1396147930
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Entity Type | Individual
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Provider Name | PATRICK JOSEPH TROY AGACNP-BC
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Gender | Male
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Dates
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Enumeration Date | 09/25/2014
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Last Update Date | 10/19/2015
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Provider Practice Location Address
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Address Line | 22201 MOROSS RD STE. 365
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City | DETROIT
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State | MI
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Zip | 48236-2169
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Country | US
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Telephone | 313-343-4886
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Fax | 313-343-4120
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Provider Business Mailing Address
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Address Line | 22201 MOROSS RD STE. 365
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City | DETROIT
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State | MI
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Zip | 48236-2169
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Country | US
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Telephone | 313-343-4886
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Fax | 313-343-4120
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 4704292714
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 4704292714
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License Number State | MI
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