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General NPI Number Information
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NPI Number | 1508574914
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Entity Type | Individual
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Provider Name | RIMA KANAAN CHARARA NP
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Gender | Female
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Dates
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Enumeration Date | 11/14/2022
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Last Update Date | 05/31/2025
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Provider Practice Location Address
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Address Line | 3270 GREENFIELD RD
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City | BERKLEY
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State | MI
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Zip | 48072-1161
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Country | US
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Telephone | 248-268-1525
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Fax |
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Provider Business Mailing Address
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Address Line | 5718 N MELBORN ST
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-2334
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Country | US
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Telephone | 313-384-5150
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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 | 4704341278
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License Number State | MI
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