MEDICARE: MRS. CONNIE M MARKEL 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
1	363LA2100X	Acute Care Nurse Practitioner	4704145026	MI
2	363L00000X	Nurse Practitioner	4704145026	MI

General Provider Information

NPI Number	:	1861538399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CONNIE M MARKEL NP

Provider Business Mailing Address
First Line	:	1 FORD PL STE 3A
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48202-3450
Country	:	US
Telephone Number	:	800-999-5829
Fax Number	:	313-874-1305

Provider Business Practice Location Address
First Line	:	6777 W MAPLE RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-3013
Country	:	US
Telephone Number	:	248-661-8230
Fax Number	:	248-325-0480

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	01/15/2026

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