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NPI Code Detail

MEDICARE: MRS. CHERYL MOELLER FURLONG RNC-NIC, MSN, NNP-BC

MEDICARE: MRS. CHERYL MOELLER FURLONG RNC-NIC, MSN, NNP-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
1363LN0005XCritical Care Neonatal Nurse Practitioner4704119019MI
2363LN0000XNeonatal Nurse Practitioner4704119019MI

Other Identifiers

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

General Provider Information

NPI Number : 1851340673
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHERYL MOELLER FURLONG RNC-NIC, MSN, NNP-BC
Provider Business Mailing Address
First Line : 40702 CRABTREE LN
Second Line :
City : PLYMOUTH
State : MI
Zip : 48170-2742
Country : US
Telephone Number : 734-420-3090
Fax Number :
Provider Business Practice Location Address
First Line : 36475 FIVE MILE RD
Second Line :
City : LIVONIA
State : MI
Zip : 48154-1971
Country : US
Telephone Number : 734-655-1183
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2006
Last Update Date : 04/28/2015

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