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General NPI Number Information
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NPI Number | 1770911703
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Entity Type | Organization
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Legal Business Name | ROMANCARE HEALTH SERVICES
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Dates
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Enumeration Date | 10/30/2013
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Last Update Date | 01/11/2017
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Provider Practice Location Address
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Address Line | 9600 DEXTER AVE
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City | DETROIT
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State | MI
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Zip | 48206-1816
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Country | US
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Telephone | 248-218-1199
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Fax | 248-218-1888
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Provider Business Mailing Address
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Address Line | 9600 DEXTER AVE
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City | DETROIT
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State | MI
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Zip | 48206-1816
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Country | US
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Telephone | 248-218-1198
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Fax | 248-218-1888
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Authorized Official
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Title or Position | CNO
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Name | MS. ANGELA L ROMAN
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Credential | FNP-BC
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Telephone | 313-575-4178
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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 |
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License Number State |
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