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General NPI Number Information
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NPI Number | 1447950498
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Entity Type | Individual
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Provider Name | ENKELEDA SHEHU
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Gender | Female
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Dates
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Enumeration Date | 03/08/2023
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Last Update Date | 03/08/2023
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Provider Practice Location Address
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Address Line | 15855 19 MILE RD
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City | CLINTON TWP
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State | MI
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Zip | 48038-3504
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Country | US
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Telephone | 248-918-1913
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Fax |
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Provider Business Mailing Address
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Address Line | 1596 CHARLEVOIS DR
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City | TROY
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State | MI
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Zip | 48085-5051
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Country | US
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Telephone | 248-635-5533
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704305819NSA220A4
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License Number State | MI
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