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NPI Code Detail

MEDICARE: MS. SHATERIA MICHELLE BOONE

MEDICARE: MS. SHATERIA MICHELLE BOONE
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner4704229347MI

General Provider Information

NPI Number : 1316799281
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHATERIA MICHELLE BOONE
Provider Business Mailing Address
First Line : 26791 SILVER CREEK CT
Second Line :
City : BROWNSTOWN
State : MI
Zip : 48134-1182
Country : US
Telephone Number : 313-304-0408
Fax Number : 866-551-4017
Provider Business Practice Location Address
First Line : 6309 MACK AVE
Second Line :
City : DETROIT
State : MI
Zip : 48207-2302
Country : US
Telephone Number : 888-813-8326
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2024
Last Update Date : 04/12/2026

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Directions to “ MS. SHATERIA MICHELLE BOONE ” Practice Location

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