Doctor Name: | DEBORAH SUE VENDITTELLI |
NPI Number: | 1023307816 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 4704113640 |
Business Practice Address: | 1 William Carls Dr Commerce Township, MI - 483822201 |
Business Phone Number: | 2499373300 |
Business Fax Number: | |
Mailing Address: | 1 William Carls Dr, COMMERCE TOWNSHIP |
State: | MI |
Postal Code: | 483822201 |
Phone Number: | 2499373300 |
Fax Number: | |
NPI Enumeration Date: | 03/31/2011 |
NPI Last Update Date: | 03/31/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LX0106X |
License Number: | 4704113640 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Occupational Health |
Taxonomy Definition: |