Doctor Name: | JENNIFER MICHELLE FIERENS |
NPI Number: | 1205184017 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 4704172353 |
Business Practice Address: | 31360 Bingham Rd Bingham Farms, MI - 480254336 |
Business Phone Number: | 5868725912 |
Business Fax Number: | |
Mailing Address: | 31360 Bingham Rd, BINGHAM FARMS |
State: | MI |
Postal Code: | 480254336 |
Phone Number: | 5868725912 |
Fax Number: | |
NPI Enumeration Date: | 08/28/2012 |
NPI Last Update Date: | 11/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4704172353 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |