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General NPI Number Information
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NPI Number | 1659041127
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Entity Type | Individual
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Provider Name | IRSIDA XHIHANI MSN, APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 5701 BOW POINTE DR STE 335
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City | CLARKSTON
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State | MI
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Zip | 48346-5403
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Country | US
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Telephone | 248-707-3132
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Fax |
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Provider Business Mailing Address
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Address Line | 31500 TELEGRAPH ROAD SUITE 010
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City | BINGHAM FARMS
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State | MI
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Zip | 48025
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Country | US
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Telephone |
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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 | 4704325379
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License Number State | MI
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