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General NPI Number Information
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NPI Number | 1881643302
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Entity Type | Individual
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Provider Name | REBECCA J COCCIA N.P.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4000 N MICHIGAN RD
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City | DIMONDALE
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State | MI
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Zip | 48821-9744
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Country | US
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Telephone | 517-646-6258
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Fax |
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Provider Business Mailing Address
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Address Line | 21333 HAGGERTY RD STE 150
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City | NOVI
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State | MI
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Zip | 48375-5510
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Country | US
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Telephone | 248-662-0250
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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 | 4704170853
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License Number State | MI
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