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NPI 1902382203

NPI 1902382203 : RACHEL NELSON NP : WEST BLOOMFIELD, MI

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General NPI Number Information
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    NPI Number           |    1902382203
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    Entity Type          |    Individual 
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    Provider Name        |    RACHEL NELSON NP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/19/2018
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    Last Update Date     |    09/22/2025
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Provider Practice Location Address
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    Address Line         |    6777 W MAPLE RD 
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    City                 |    WEST BLOOMFIELD
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    State                |    MI
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    Zip                  |    48322-3013
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    Country              |    US
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    Telephone            |    248-325-1000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1 FORD PL STE 3A 
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    City                 |    DETROIT
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    State                |    MI
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    Zip                  |    48202-3450
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    Country              |    US
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    Telephone            |    313-874-4806
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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       |    4704223084
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    License Number State |    MI
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Taxonomy #2
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    Taxonomy Code        |    363LG0600X
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    Taxonomy Name        |    Gerontology Nurse Practitioner
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    License Number       |    4704223084
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    License Number State |    MI
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