Organization Name: | WCHC-HAMTRAMCK HEALTH CENTER |
NPI Number: | 1477955656 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CAREEA NORDE (OPERATIONS MANAGER) |
Mailing Address: | 11447 Joseph Campau St Hamtramck |
State: | MI US |
Postal Code: | 482123040 |
Phone Number: | 3133651362 |
Fax Number: | |
NPI Enumeration Date: | 09/19/2014 |
NPI Last Update Date: | 09/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 4704267756 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |