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NPI Code Detail

MEDICARE: JENNIFER RUEL NP

MEDICARE:   JENNIFER  RUEL  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 Practitioner4704219489MI

Other Identifiers

General Provider Information

NPI Number : 1811975022
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER RUEL NP
Provider Business Mailing Address
First Line : 4050 W MAPLE RD
Second Line : SUITE 101
City : BLOOMFIELD HILLS
State : MI
Zip : 48301-3148
Country : US
Telephone Number : 248-885-8211
Fax Number : 248-885-8357
Provider Business Practice Location Address
First Line : 3500 15 MILE RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-5353
Country : US
Telephone Number : 586-977-6212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 06/14/2016

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