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NPI Code Detail

MEDICARE: NORA S CREIGHTON FNP-BC

MEDICARE: NORA S CREIGHTON FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner4704160314MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14704160314OTHERMISTATE LICENSE

General Provider Information

NPI Number : 1093820573
Entity Type Code : Individual
Provider Name (Legal Business Name) : NORA S CREIGHTON FNP-BC
Provider Business Mailing Address
First Line : 19020 FORT ST
Second Line :
City : RIVERVIEW
State : MI
Zip : 48193-6701
Country : US
Telephone Number : 734-362-5100
Fax Number : 734-362-5147
Provider Business Practice Location Address
First Line : 19020 FORT ST
Second Line :
City : RIVERVIEW
State : MI
Zip : 48193-6701
Country : US
Telephone Number : 734-362-5100
Fax Number : 734-362-5147
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2006
Last Update Date : 03/07/2023

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Directions to “ NORA S CREIGHTON FNP-BC” Practice Location

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