Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 4704297446 | MI |
NPI | 1427534312 |
---|---|
Provider Name | Angela Rose Rizzi |
First Address | Warren, MI 48092-6306 |
Second Address | Royal Oak, MI 48073-6712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2018 |
Last Update Date | 14/07/2018 |