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NPI Code Detail

MEDICARE: MRS. MELISSA ANN MORTON-PASSERMAN NP

MEDICARE: MRS. MELISSA ANN MORTON-PASSERMAN 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
1163W00000XRegistered Nurse4704230148MI
2363LP2300XPrimary Care Nurse Practitioner4704230148MI
3363LA2200XAdult Health Nurse Practitioner4704230148MI

General Provider Information

NPI Number : 1568546372
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELISSA ANN MORTON-PASSERMAN NP
Provider Business Mailing Address
First Line : 14183 DEERING ST
Second Line :
City : LIVONIA
State : MI
Zip : 48154-4617
Country : US
Telephone Number : 248-444-8869
Fax Number :
Provider Business Practice Location Address
First Line : 3370 E JEFFERSON AVE
Second Line :
City : DETROIT
State : MI
Zip : 48207-4236
Country : US
Telephone Number : 313-656-1600
Fax Number : 313-656-1610
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 03/12/2021

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