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NPI Code Detail

MEDICARE: CHARLI MARIE SOUZA FNP-BC

MEDICARE: CHARLI MARIE SOUZA 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 Practitioner2019082597MI

General Provider Information

NPI Number : 1477193134
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLI MARIE SOUZA FNP-BC
Provider Business Mailing Address
First Line : 3074 FLORENCE CT
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48309-4087
Country : US
Telephone Number : 810-887-1046
Fax Number :
Provider Business Practice Location Address
First Line : 3010 WALTON BLVD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48309-1264
Country : US
Telephone Number : 866-389-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2020
Last Update Date : 10/23/2024

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Directions to “ CHARLI MARIE SOUZA FNP-BC” Practice Location

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