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General NPI Number Information
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NPI Number | 1902349160
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Entity Type | Organization
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Legal Business Name | SENIOR HEALTH PARTNER
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Dates
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Enumeration Date | 11/21/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 10140 VERNOR HWY
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City | DEARBORN
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State | MI
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Zip | 48120-1515
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Country | US
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Telephone | 313-413-8684
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Fax | 888-242-0942
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Provider Business Mailing Address
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Address Line | PO BOX 7060
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City | DEARBORN
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State | MI
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Zip | 48121-7060
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Country | US
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Telephone | 313-355-9800
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Fax | 313-557-0144
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. VERA JABER
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Credential | NP-C
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Telephone | 313-384-3069
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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 | 4704267744
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License Number State | MI
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