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NPI Code Detail

MEDICARE: CHERYL A GRAIN NP

MEDICARE: CHERYL A GRAIN NP
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
1363L00000XNurse Practitioner4704126733MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2500F31819OTHERMIBCBSM

General Provider Information

NPI Number : 1437155538
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL A GRAIN NP
Provider Business Mailing Address
First Line : 3601 W 13 MILE RD
Second Line : FSC
City : ROYAL OAK
State : MI
Zip : 48073-6712
Country : US
Telephone Number : 248-423-2454
Fax Number : 248-423-2576
Provider Business Practice Location Address
First Line : 3601 W 13 MILE RD
Second Line : FSC
City : ROYAL OAK
State : MI
Zip : 48073-6712
Country : US
Telephone Number : 248-423-2454
Fax Number : 248-423-2576
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 02/15/2021

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